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

Background: Psoriasis is a chronic recurrent inflammatory skin disease with a high risk of diabetes based on disease severity. Objectives: The aim of the study was to evaluate the efficacy of different hypoglycemic medications in patients with psoriasis. Methods: 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. Results: 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, p = 0.0007) and a higher PASI75 ratio (RR: 1.80, 95% CI: 1.20–2.71, p = 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 (p = 0.0216). In addition, hypoglycemic medications can reduce body weight, waist circumference, triglyceride, total cholesterol, low-density lipoprotein, and systolic blood pressure. Conclusions: 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.背景：银屑病是一种慢性复发性炎症性皮肤病，患者罹患糖尿病的风险随疾病严重程度升高而增加。 研究目的：本研究旨在评估不同降糖药物对银屑病患者的治疗效果。 研究方法：本研究通过系统评价与Meta分析，评估降糖药物对银屑病患者的治疗效果。本研究的主要结局指标包括银屑病面积与严重程度指数（Psoriasis Area and Severity Index, PASI）评分变化，以及较基线实现75%改善的PASI75比例。通过亚组分析，探讨降糖药物类型、联合治疗方案、患者特征、治疗疗程与临床疗效之间的关联。 研究结果：本研究共纳入19项研究的3286例患者，以探讨降糖药物的治疗效应。随机分配接受降糖药物治疗的患者，其PASI评分下降更为显著（标准化均数差 = -0.55，95%置信区间（Confidence Interval, CI）：-0.87 ~ -0.23，p = 0.0007），且PASI75达标率更高（相对风险（Relative Risk, RR）= 1.80，95% CI：1.20 ~ 2.71，p = 0.0046）。相较于使用胰高血糖素样肽-1受体激动剂（glucagon-like peptide 1 receptor agonists, GLP-1 RAs）与二肽基肽酶4抑制剂的患者，服用噻唑烷二酮类（thiazolidinediones, TZDs）的患者更易达到PASI75标准。降糖药物联合治疗对银屑病标准治疗具有附加获益，联合治疗组的PASI75达标率几乎为非联合组的4倍（p = 0.0216）。此外，降糖药物可降低患者体重、腰围、甘油三酯、总胆固醇、低密度脂蛋白胆固醇及收缩压水平。 研究结论：部分降糖药物（如GLP-1 RAs与TZDs）对银屑病治疗具有积极获益。建议通过多学科协作，管理银屑病合并糖尿病患者的全身炎症状态。