A Prospective, Open Label, Randomized Control Trial to Evaluate the Efficacy, Changes in Quality of Life and Treatment Adherence of Oral Rosuvastatin in Management of Plaque Psoriasis

Background: Psoriasis is a chronic, autoimmune, inflammatory disease characterized by scaly red patches on the skin that has great negative effect on quality of life. Rosuvastatin, a lipid-lowering medication, is considered a promising drug in treating plaque psoriasis due to their pleiotropic effect. Objectives: To evaluate efficacy of oral rosuvastatin with escalating doses on mild to moderate plaque psoriasis with Psoriasis Area and Severity Index (PASI), to assess the effectiveness of rosuvastatin in improving quality of life using Dermatology Life Quality Index (DLQI), and to assess medication adherence using Medication Adherence Rating Scale (MARS). Methods: An open label, randomized control trial, where 52 patients with plaque psoriasis were enrolled after considering inclusion and exclusion criteria. Patients were randomly divided into four groups: a control group that received standard therapy consisting of topical glucocorticoids, antihistaminic and skin emollient and treatment groups receiving 5mg,10mg, 20 mg of rosuvastatin along with standard treatment continued daily for 8 weeks. Patients were assessed for PASI, DLQI scores, routine blood parameters and LFT tests done at baseline,4 weeks and 8 weeks, while MARS was assessed at 4 weeks and 8 weeks. Results were statistically analysed using GraphPad Prism version 9 software. For intragroup comparison at 0, 4 and 8 weeks, repeated measures ANOVA was done. Intergroup comparisons were done by one-way ANOVA and statistical significance implied by p value<0.05. Results: At the end of the study, while on intragroup comparison all the groups showed significant improvement in PASI (p<0.0001), DLQI (p<0.0001) and MARS score (p<0.0001) at 4 weeks and 8 weeks, on intergroup comparison, none of the intervention groups had any significant advantage over the control group in terms of change of PASI, DLQI or MARS across the study duration. There was also a significant rise in hepatic ALT (p<0.001) and AST (p<0.001) enzymes levels in all the rosuvastatin receiving groups while the control group had a reduction in the ALT levels (p = 0.0012). Conclusion: Oral rosuvastatin in any of the clinically given doses of 5 mg, 10 mg or 20 mg failed to provide any extra benefits when added to the standard treatment of topical glucocorticoids, antihistaminic and skin emollient cream.