Supplementary Material for: Effect of Different Types of Hypoglycemic Medications on Psoriasis: An Analysis of Current Evidence

<b><i>Background:</i></b> Psoriasis is a chronic recurrent inflammatory skin disease with a high risk of diabetes based on disease severity. <b><i>Objectives:</i></b> The aim of the study was to evaluate the efficacy of different hypoglycemic medications in patients with psoriasis. <b><i>Methods:</i></b> A systematic review and meta-analysis of studies were conducted to evaluate the efficacy of hypoglycemic medications in patients with psoriasis. The primary outcome was of changes in the psoriasis area and severity index (PASI) score, and a 75% improvement in PASI from baseline (PASI75). Subgroup analysis was used to investigate associations among the types of hypoglycemic medicines, combination therapy, patient characteristics, course of treatment, and curative effect. <b><i>Results:</i></b> We included 3,286 patients from 19 studies to explore the effects of hypoglycemic medications. Patients randomized to receive hypoglycemic medicines showed a more significant decrease in the PASI score (standard mean difference = −0.55, 95% confidence interval (CI): −0.87 to −0.23, <i>p</i> = 0.0007) and a higher PASI75 ratio (RR: 1.80, 95% CI: 1.20–2.71, <i>p</i> = 0.0046). Patients consuming thiazolidinediones (TZDs) were more likely to reach PASI75 than those consuming glucagon-like peptide 1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase 4 inhibitors. The combined use of hypoglycemic medicines had an add-on effect on the standard psoriasis treatment, and the proportion of PASI75 in the combination group was nearly four times that in the noncombination group (<i>p</i> = 0.0216). In addition, hypoglycemic medications can reduce body weight, waist circumference, triglyceride, total cholesterol, low-density lipoprotein, and systolic blood pressure. <b><i>Conclusions:</i></b> Certain hypoglycemic drugs, such as GLP-1 RAs and TZDs, are beneficial for treating psoriasis. Multidisciplinary collaboration is recommended for the management of systemic inflammation in patients with psoriasis and diabetes.

<b><i>背景：</i></b> 银屑病（Psoriasis）是一种慢性复发性炎症性皮肤病，患者的糖尿病发病风险与疾病严重程度相关。<b><i>目的：</i></b> 本研究旨在评估不同降糖药物在银屑病患者中的治疗疗效。<b><i>方法：</i></b> 本研究开展系统评价与荟萃分析，以探究降糖药物在银屑病患者中的治疗效果。本研究的主要结局指标为银屑病面积与严重程度指数（PASI，psoriasis area and severity index）评分变化，以及较基线水平改善75%的PASI评分（PASI75）。采用亚组分析，探讨降糖药物类型、联合治疗、患者特征、治疗疗程与疗效之间的关联。<b><i>结果：</i></b> 本研究共纳入19项研究、3286例患者，以分析降糖药物的治疗效应。随机接受降糖药物治疗的患者，其PASI评分下降更为显著（标准均数差=-0.55，95%置信区间（CI，confidence interval）：-0.87至-0.23，p=0.0007），且PASI75应答率更高（相对风险RR=1.80，95%CI：1.20至2.71，p=0.0046）。相较于使用胰高糖素样肽-1受体激动剂（GLP-1 RAs，glucagon-like peptide 1 receptor agonists）与二肽基肽酶4抑制剂的患者，接受噻唑烷二酮类（TZDs，thiazolidinediones）治疗的患者更易达到PASI75。降糖药物联合使用对银屑病标准治疗具有附加疗效，联合治疗组的PASI75占比约为非联合治疗组的4倍（p=0.0216）。此外，降糖药物还可降低患者体重、腰围、甘油三酯、总胆固醇、低密度脂蛋白水平以及收缩压。<b><i>结论：</i></b> 部分降糖药物（如GLP-1 RAs与TZDs）对银屑病治疗具有获益。建议采用多学科协作模式，管理银屑病合并糖尿病患者的全身炎症反应。