Is Metformin a Possible Beneficial Treatment for Psoriasis? A Scoping Review

Abstract

Psoriasis is a chronic inflammatory condition with genetic, immunological, and metabolic etiology. The link between psoriasis and diabetes mellitus has been shown in genetic predisposition, environmental influences, inflammatory pathways, and insulin resistance, resulting in end-organ damage in both conditions. Because comorbidities often accompany psoriasis, the therapeutic management of the disease must also take into consideration the comorbidities. Given that metformin's therapeutic role in psoriasis is not yet fully elucidated, we raised the question of whether metformin is a viable alternative for the treatment of psoriasis. We conducted this scoping review by searching for evidence in PubMed, Cochrane, and Scopus databases, and we used an extension for scoping reviews (PRISMA-ScR). Current evidence suggests that metformin is safe to use in psoriasis. Studies have shown an excellent therapeutic response to metformin in patients with psoriasis and comorbidities such as diabetes, metabolic syndrome, and obesity. There is no clear evidence supporting metformin monotherapy in patients with psoriasis without comorbidities. There is a need to further evaluate metformin in larger clinical trials, as a therapy in psoriasis.

Keywords: metabolic syndrome; metformin; psoriasis.

Figure 1

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow diagram.

Figure 2

Several drugs have been implicated in psoriasiform drug eruptions, trigger new-onset psoriasis, or exacerbate existing psoriasis [67,68,69,70,71,72,73,74].