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n-3 Polysaturated Fatty Acids-rich Diet in Psoriasis (PSO)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01876875
Recruitment Status : Completed
First Posted : June 13, 2013
Last Update Posted : June 13, 2013
Information provided by (Responsible Party):
Eleonora Riccio, Federico II University

Brief Summary:

Low-grade systemic inflammation associated with obesity may worsen the clinical course of psoriasis. Both a low-calorie diet and nutritional supplementation have been shown to have an impact on the clinical course of psoriasis, including an anti-inflammatory effect of n-3 polyunsaturated fatty acids (PUFAs). This study aimed to assess the effectiveness of an energy-restricted diet, enriched in n-3 PUFAs and poor in n-6 PUFAs, on metabolic markers and clinical outcome of obese patients with psoriasis.

Methods: Forty-four obese patients with mild-to-severe plaque-type psoriasis treated with immuno-suppressive drugs were randomized to assume either their usual diet or an energy-restricted diet (20 kcal/kg/ideal body weight/day) enriched of n-3 PUFAs (average 2.6 g/d). All patients continued their immuno-modulating therapy throughout the study. End-point measures included anthropometric, biochemical and clinical parameters at baseline, 3 and 6 months.

Condition or disease Intervention/treatment Phase
Plaque-type Psoriasis Obesity (Body Mass Index >30 kg/m2) Dietary Supplement: Energy-restricted, n-3 polysaturated fatty acids-rich diet Dietary Supplement: Usual diet Phase 4

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 44 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Energy-restricted, n-3 Polysaturated Fatty Acids-rich Diet Improves the Clinical Response to Immuno-modulating Drugs in Obese Patients With Plaque-type Psoriasis: a Randomized Control Clinical Trial.
Study Start Date : April 2007
Actual Primary Completion Date : October 2008
Actual Study Completion Date : October 2008

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Psoriasis

Arm Intervention/treatment
Experimental: Intervention group
The patients of this group were randomized to receive an energy-restricted diet (20 kcal/kg/ideal body weight/day) enriched of n-3 PUFAs (average 2.6 g/d).
Dietary Supplement: Energy-restricted, n-3 polysaturated fatty acids-rich diet
The active diet aimed to reduce body weight, to enhance the total intake of n-3 PUFA and to decrease the total intake of n-6 PUFAs. The diet plan was designed to supply an energy intake of 20 kcal/kg/day to maintain an ideal body weight, and followed the guidelines of the American Heart Association (AHA) 'Step-One' Diet: Carbohydrates (mainly complex carbohydrates) and protein constituted of 50-60% and 10-20% of total calories, respectively, and total fat did not exceed 30% of calories. Food values for energy and nutrients were taken from the tables of the Italian National Institute of Nutrition, Souci's Food Composition and Nutrition Tables and the European Institute of Oncology. For long-term and practical daily eating habits, it was important to easily incorporate and consume a variety of selected foods.

Active Comparator: Control group
The participants of this group are randomized to receive drug therapy alone, continuing their usual diet
Dietary Supplement: Usual diet
The patients of this group were randomized to continue their usual diet

Primary Outcome Measures :
  1. Composite outcome of Metabolic markers [ Time Frame: 6 months ]
    Fasting blood samples were drawn for the following measurements: serum total cholesterol, HDL-cholesterol (HDL-C), LDL-C, triglycerides, fibrinogen and serum glucose. Serum LDL-C concentration was calculated using the Friedewald equation.

  2. Composite outcome of Anthropometric measurements [ Time Frame: 6 months ]
    BMI was calculated as the ratio of body weight to height2 (kg/m2). Waist circumference was measured with an inelastic tape, the subject in standing position, at the level of the umbilicus. According to the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria,abdominal obesity was defined as waist circumference ≥102 cm in men and ≥88 cm in women

  3. Composite outcome of Clinical assessments [ Time Frame: 6 months ]

    Clinical assessment was based on three separate instruments: Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), and VAS for subjective itch ratings.

    The PASI is used for measuring psoriasis severity. The scale evaluates four areas of the body (head/neck, upper limbs, trunk, and lower limbs) for erythema, scaliness and thickness of psoriatic plaques. The PASI score can range from 0 to 72, with higher scores indicating greater severity.

    The DLQI is a self-rated instrument consisting of ten items related to the ways that skin disease may impact a patient's health-related quality of life (HRQL). Scores are based on six subscales and has a possible range 0 to 30, with 30 corresponding to the worst HRQL.

    Subjective itch ratings were recorded using a computerized VAS, anchored by the terms "no itching" (0 points) and "severe itching" (10 points). Subjects were asked to respond in terms of their itching "at the present time".

  4. Composite outcome of Dietary assessment [ Time Frame: 6 months ]
    Dietary compliance was evaluated by experienced dietitians trained for this project, using a combination of food diaries, personal interviews and a detailed food-frequency questionnaire that included 130 foods and beverages. Information on diet included weekly frequency of consumption and portion size. Average daily intakes were calculated by using food tables and industry estimates of the n-3 naturally-rich margarine. Total dietary n3 PUFAs refers to the intake of ALA in addition to of long-chain EPA and DHA.

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • body mass index (BMI) >30 kg/m2,
  • age ≥18 years
  • clinical diagnosis of plaque-type psoriasis,
  • mild-to-severe psoriasis clinically stable for at least 5 months
  • no change in psoriasis therapies for at least five months

Exclusion Criteria:

  • diabetes,
  • malignancy,
  • history of food intolerance or autoimmune disorders,
  • patients non-collaborative

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01876875

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federico II University
Naples, Italy, 80129
Sponsors and Collaborators
Federico II University
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Eleonora Riccio, md, Federico II University Identifier: NCT01876875    
Other Study ID Numbers: Cataldi13
CAT ( Other Identifier: ethic commettee )
First Posted: June 13, 2013    Key Record Dates
Last Update Posted: June 13, 2013
Last Verified: October 2008
Keywords provided by Eleonora Riccio, Federico II University:
Additional relevant MeSH terms:
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Skin Diseases, Papulosquamous
Skin Diseases