Effect of statins on psoriasis severity: A meta‐analysis of randomized clinical trials

Abstract

Abstract Background Psoriasis, a chronic inflammatory skin disorder, is associated with an elevated risk of cardiovascular diseases due to shared inflammatory pathways. This meta‐analysis evaluates the efficacy of statins, known for their lipid‐lowering and anti‐inflammatory properties, in managing psoriasis severity. Methods A systematic search was conducted following Preferred Reporting Items for Systematic reviews and meta‐analysis guidelines across PubMed, Cochrane, Web of Science, Scopus, EMBASE, and CINAHL databases up to October 2024. Randomized clinical trials comparing statins with placebo or alternative treatments in adult psoriasis patients were included. The primary outcome was the Psoriasis Area and Severity Index (PASI) score or symptom improvement. Results Out of 11,894 identified articles, 10 randomized clinical trials were included in the final analysis. Data from eight studies with 638 observations revealed a standardized mean difference (SMD) of −0.36 (95% confidence intervals [CI]: −0.72 to 0.00; p = 0.05; I ² = 52.0% [95% CI: 0.0% to 79.5%]) for PASI scores, indicating a beneficial effect of statins on psoriasis severity, although not statistically significant. Subgroup analysis demonstrated significant effects for topical administration (SMD = −0.82; 95% CI: −1.47 to −0.16; I 2 = 0%). Secondary outcomes, measured using the Dermatology Life Quality Index (DLQI), were assessed in three studies (232 observations) and showed an SMD of 0.24 (95% CI: −0.09 to 0.57; p = 0.1; I 2 = 0%), indicating no significant improvement in DLQI scores. Analysis of high‐sensitivity C‐reactive protein (hsCRP) from two studies (164 observations) revealed an SMD of −0.12 (95% CI: −0.42 to 0.18; p = 0.44; I 2 = 0%), indicating no significant reduction in systemic inflammation. Conclusions While statins may reduce psoriasis severity, the meta‐analysis did not show statistically significant improvements in PASI scores, except for topical application, and found no significant benefits in DLQI or hsCRP levels. Variability across studies and small sample sizes are notable limitations. Future research with larger cohorts and extended follow‐ups is warranted to clarify the potential role of statins in psoriasis management.