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维生素 D 补充剂治疗银屑病的疗效和安全性:系统评价和荟萃分析。

Efficacy and safety of vitamin D supplementation on psoriasis: A systematic review and meta-analysis.

机构信息

Tianjin University of Traditional Chinese Medicine, Tianjin, China.

Department of Dermatology, Shushan TCM Clinic, Anhui Xin'an TCM Medical Service Co., LTD., Hefei, China.

出版信息

PLoS One. 2023 Nov 15;18(11):e0294239. doi: 10.1371/journal.pone.0294239. eCollection 2023.

Abstract

OBJECTIVES

Our aim was to analyze the results of published randomized controlled trials (RCTs) on vitamin D supplementation for psoriasis in order to explore its effectiveness and safety.

PATIENTS AND METHODS

As of July 7 2023, we conducted a systematic literature search in PubMed, Cochrane, Embase, and Web of Science Core Collection databases. The study outcomes included change values in Psoriasis Area and Severity Index (PASI) (at 3 months, 6 months, and end of follow-up)/Dermatology Life Quality Index (DLQI)/Psoriasis disability index (PDI)/C-reactive protein (CRP), and adverse events.

RESULTS

333 patients from 4 studies were evaluated. Pooled analyses showed no significant effect of DLQI/PDI/CRP change value (P > 0.05) or PASI change value (3 months, end of follow-up; P > 0.05). Sensitivity analyses and statistical tests did not support the results of the PASI change values (6 months, P = 0.05). However, the results of subgroup analyses should not be ignored(supplementation with vitamin D2 or Asia would be more effective; P = 0.03). There were no serious adverse effects, and only a few individuals experienced nausea.

CONCLUSIONS

The efficacy and safety of vitamin D supplementation in the treatment of psoriasis remains unremarkable. The search for a new prognostic index that combines clinical and laboratory factors is needed to compensate for the shortcomings of existing measures and provide stronger evidence of validity.

摘要

目的

分析已发表的关于维生素 D 补充治疗银屑病的随机对照试验(RCT)的结果,以探讨其疗效和安全性。

患者和方法

截至 2023 年 7 月 7 日,我们在 PubMed、Cochrane、Embase 和 Web of Science 核心合集数据库中进行了系统文献检索。研究结局包括银屑病面积和严重程度指数(PASI)(3 个月、6 个月和随访结束时)/皮肤病生活质量指数(DLQI)/银屑病残疾指数(PDI)/C 反应蛋白(CRP)的变化值和不良事件。

结果

4 项研究的 333 例患者被评估。汇总分析显示,DLQI/PDI/CRP 变化值(P > 0.05)或 PASI 变化值(3 个月,随访结束时;P > 0.05)无显著影响。敏感性分析和统计检验不支持 PASI 变化值(6 个月,P = 0.05)的结果。然而,亚组分析的结果不容忽视(补充维生素 D2 或亚洲地区可能更有效;P = 0.03)。没有严重的不良事件,只有少数人出现恶心。

结论

维生素 D 补充治疗银屑病的疗效和安全性仍不显著。需要寻找一种新的预后指标,将临床和实验室因素相结合,以弥补现有措施的不足,并提供更有力的有效性证据。

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本文引用的文献

1
Psoriasis and Vitamin D: A Systematic Review and Meta-Analysis.
Nutrients. 2023 Jul 30;15(15):3387. doi: 10.3390/nu15153387.
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Dermatol Ther (Heidelb). 2021 Jun;11(3):1053-1064. doi: 10.1007/s13555-021-00518-8. Epub 2021 Apr 22.
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