Atorvastatin for the treatment of plaque-type psoriasis.

Study Objective: To explore the efficacy and safety of oral atorvastatin for the treatment of plaque-type psoriasis.

Design: Prospective, randomized, double-blind, placebo-controlled study.

Setting: University-affiliated psoriasis outpatient clinic in Iran.

Patients: Forty-two patients aged 16-60 years with a diagnosis of acute or chronic plaque-type psoriasis with body surface area (BSA) involvement of greater than 10% were enrolled; 40 completed the study. Intervention. Oral atorvastatin 40 mg/day (20 patients) or placebo (20 patients) was administered for 12 weeks; patients' topical therapies with emollients, keratolytics, and/or class V corticosteroids were continued during the study period.

Measurements And Main Results: The Psoriasis Area and Severity Index (PASI) and percentage BSA involvement were used to assess the efficacy of therapy. Mean ± SD baseline PASI scores were 7.42 ± 1.90 and 6.92 ± 1.76 in the atorvastatin and placebo groups, respectively. The primary outcomes were the degree of change in PASI scores and percentage BSA involvement from baseline to week 12. Significant improvement in psoriasis lesions was observed in both the atorvastatin and placebo groups (p<0.001 for both groups). A 75% improvement in PASI score (PASI 75) was achieved in 8 patients (40%) in the atorvastatin group and 7 patients (35%) in the placebo group. However, no statistically significant differences were noted between the two treatment groups in mean PASI score, percentage BSA involvement, and PASI 75. In terms of adverse effects, atorvastatin was well tolerated.

Conclusion: Oral atorvastatin 40 mg/day was not associated with therapeutic benefit when given to patients with baseline PASI scores less than 12 who were also treated with standard topical therapies. Additional trials are needed to elucidate the place of statins for the treatment of psoriasis. A larger follow-up study, as well as testing atorvastatin in patients with more intensive disease characterized by high PASI scores, is needed. Studies using higher atorvastatin doses or dose-ranging studies should also be performed.