Atorvastatin for the Treatment of Plaque-type Psoriasis

Toktam Faghihi, Mania Radfar, Zohre Mehrabian, Amir Hoshang Ehsani, and Mohsen Rezaei Hemami,

Pharmacotherapy. 2011;31(11):1045-1050.

Conclusion

Atorvastatin 40 mg/day was not significantly more effective than placebo in the treatment of plaque-type psoriasis in patients with baseline PASI scores less than 12 and receiving standard topical psoriasis therapy. Any therapeutic benefit was attributed to the effects of emollients and the topical therapies applied concomitantly. The lack of significant effect from atorvastatin could be attributed to the patient population, which had relatively low baseline PASI scores. Additional trials are needed to elucidate the place of atorvastatin and other statins for the treatment of psoriasis. We propose a larger follow-up study as well as testing atorvastatin in a more severely affected group characterized by high PASI scores. Further testing with atorvastatin in high doses, rather than standard doses, or in a dose-ranging study is recommended.

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Table 1. Baseline Characteristics of the Study Patients
Characteristic	Atorvastatin Group (n=20)	Placebo Group (n=20)
Age, yrs (mean ± SD)	43.85 ± 14.32	36.55 ± 12.11
	No. (%) of Patients
Sex
Male	8 (40)	12 (60)
Female	12 (60)	8 (40)
Psoriasis subtype^a
Acute	1 (5)	4 (20)
Chronic	19 (95)	16 (80)
Previous
pharmacotherapy for psoriasis^b
None	10 (50)	11 (55)
Topical	3 (15)	6 (30)
Systemic	6 (30)	2 (10)
Phototherapy	1 (5)	0 (0)
Topical + systemic	0 (0)	1 (5)

^aAcute psoriatic plaque was defined as a lesion of less than 6 weeks' duration; otherwise, the plaque was considered chronic.
^bAll patients had discontinued systemic therapy and phototherapy within 30 days and topical therapies within 14 days before study entry.

Table 2. Treatment Efficacy Measured by Percentage BSA Involvement and PASI Scores
Measure	Placebo Group (n=20)			Atorvastatin Group (n=20)			Group Effect Comparison
Measure	Baseline^a	Week 12^a	p Value^b	Baseline^a	Week 12^a	p Value^b	F	p Value^c
BSA (%)	32.30 ± 10.47	15.33 ± 12.02	<0.001	31.20 ± 7.27	16.43 ± 12.15	<0.001	0.37	0.54
PASI score	6.92 ± 1.76	2.59 ± 2.09	<0.001	7.42 ± 1.90	2.94 ± 2.37	<0.001	0.13	0.72

BSA = body surface area; PASI = Psoriasis Area and Severity Index.
^aData are mean ± SD.
^bp values for the comparison of mean scores between baseline and week 12, by using the paired-sample t test.
^cp values for the comparison of mean difference between placebo and atorvastatin groups, by using univariate analysis of variance adjusted for baseline values.

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Atorvastatin for the Treatment of Plaque-type Psoriasis

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