Superiority of a vitamin B-containing emollient compared to a standard emollient in the maintenance treatment of mild-to-moderate plaque psoriasis.

Ester Del Duca, Francesca Farnetani, Nathalie De Carvalho, Ugo Bottoni, Giovanni Pellacani, Steven P Nisticò

Journal: International journal of immunopathology and pharmacology 2018;30(4):439-444

PMID: 29048238

Plain Language Summary

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During inflammation, an enzyme named Nitric oxide synthase is produced, causing increased Nitric oxide production in psoriatic lesions. Vitamin B12 binds to Nitric oxide and serves as a scavenger. Earlier studies indicate that Vitamin B12 can reduce immunological factors, inflammation, and skin proliferation in people with psoriasis. This randomised, single-blinded, intra-patient, left-to-right comparison study aimed to evaluate the effectiveness of topical cream containing vitamin B12 as a therapeutic strategy in reducing psoriatic plaque lesions. 24 patients with mild-to-moderate psoriasis who were treated with emollient cream containing vitamin B12 for 16 weeks showed a reduction in the severity of psoriasis. Furthermore, vitamin B12 cream significantly reduced the severity of psoriasis compared to glycerol-petrolatum-based emollient creams. Vitamin B12 cream application also showed a great reduction in itching and psoriatic plaque formation. 16 weeks of treatment demonstrated the anti-inflammatory and immune modulatory effects of Vitamin B12 cream. To fully understand the effects of Vitamin B12 on different pathological pathways of psoriasis, further research is needed. The study can guide healthcare professionals in understanding the benefits of Vitamin B12 cream on mild-to-moderate psoriasis and its clinical applicability.

Abstract

Psoriasis is a chronic inflammatory skin disease affecting 2%-3% of the population. The wide range of drugs currently available for its treatment could be associated, in the long term, with organ toxicity and adverse events, thus, clinical monitoring throughout treatment is required. This investigator-initiated trial (IIT) evaluated the efficacy and the safety of a vitamin B-containing ointment in comparison with glycerol-petrolatum-based emollient cream used twice a day to treat mild-to-moderate plaque psoriasis for a period over 12 weeks followed by a wash-out observation period of 4 weeks. This study was conducted as a randomized, controlled, single-blind, intra-patient left- to right-side trial comparing the efficacy and safety of vitamin B-containing ointment (M-treatment) with a glycerol-petrolatum-based emollient cream (C-treatment). The Psoriasis Area Severity Index (PASI) was determined at baseline (T0), at time points T2 (14 days), T4 (4 weeks), T8 (8 weeks), T12 (12 weeks) and 4 weeks after the end of the wash-out period (F1). In total, 24 patients with plaque psoriasis were randomized to receive left- or right-side treatment with B ointment. From time point T2 to time point F1, there was a statistically significant difference in PASI reduction between M-treatment side and C-treatment side. At time point T 12, the difference between the mean reductions from baseline PASI scores by 5.92 ± 2.49 (87, 6%) in the M-treatment side versus 1.08 ± 1.02 (23, 1%) C-treatment side was statistically highly significant ( P < 0.001). On the contemporary panorama in the treatment of psoriasis, we conclude that vitamin B ointment will represent a new concrete therapy option and should be considered in the update of therapeutic algorithm for the treatment of psoriasis.

Address: 1 Division of Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.; 2 Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy.; 3 Dermatology, Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro, Italy.
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