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Open AccessArticle

The Impact of Ramadan Fasting on the Reduction of PASI Score, in Moderate-To-Severe Psoriatic Patients: A Real-Life Multicenter Study

1
Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20161 Milan, Italy
2
Young Dermatologists Italian Network (YDIN), GISED, 24122 Bergamo, Italy
3
Department of Medicine ’B’, Sheba Medical Center, Tel-Hashomer and Sackler Faculty of Medicine, Tel Aviv University, 5265601 Tel Aviv, Israel
4
Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA Leeds, UK
5
Clinical Dermatology Department, S. Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
6
Dermatology Unit, Azienda Ospedaliera San Donato Milanese, 20097 Milan, Italy
7
Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy
8
Padeh and Ziv Hospitals, Azrieli Faculty of Medicine, Bar-Ilan University, 5290002 Ramat Gan, Israel
*
Author to whom correspondence should be addressed.
Contributed equally as first authors.
Nutrients 2019, 11(2), 277; https://doi.org/10.3390/nu11020277
Received: 14 January 2019 / Revised: 23 January 2019 / Accepted: 24 January 2019 / Published: 27 January 2019
Fasting during the month of Ramadan consists of alternate abstinence and re-feeding periods (circadian or intermittent fasting). Nothing is currently known on the impact of this kind of fasting on psoriasis. A sample of 108 moderate-to-severe plaque psoriasis patients (aged 42.84 ± 13.61 years, 62 males, 46 females) volunteered to take part in the study. A significant decrease in the “Psoriasis Area and Severity Index” (PASI) score after the Ramadan fasting (mean difference = −0.89 ± 1.21, p < 0.0001) was found. At the multivariate regression, the use of cyclosporine (p = 0.0003), interleukin-17 or IL-17 blockers (p < 0.0001), and tumor necrosis factor or TNF blockers (p = 0.0107) was independently associated with a low PASI score, while the use of apremilast (p = 0.0009), and phototherapy (p = 0.0015) was associated with a high PASI score before the Ramadan fasting. Similarly, the consumption of cyclosporine (p < 0.0001), IL-17 blockers (p < 0.0001), mammalian target of rapamycin or mTOR inhibitors (p = 0.0081), and TNF blockers (p = 0.0017) predicted a low PASI score after the Ramadan fasting. By contrast, narrow band ultraviolet light B or NB-UVB (p = 0.0015) was associated with a high PASI score after Ramadan fasting. Disease duration (p = 0.0078), use of apremilast (p = 0.0005), and of mTOR inhibitors (p = 0.0034) were independent predictors of the reduction in the PASI score after the Ramadan fasting. These findings reflect the influence of dieting strategy, the biological clock, and circadian rhythm on the treatment of plaque psoriasis. View Full-Text
Keywords: plaque psoriasis; moderate-to-severe psoriatic patients; PASI score; Ramadan intermittent fasting; systemic treatment; topical treatment; biological clock; circadian rhythm plaque psoriasis; moderate-to-severe psoriatic patients; PASI score; Ramadan intermittent fasting; systemic treatment; topical treatment; biological clock; circadian rhythm
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MDPI and ACS Style

Damiani, G.; Watad, A.; Bridgewood, C.; Pigatto, P.D.M.; Pacifico, A.; Malagoli, P.; Bragazzi, N.L.; Adawi, M. The Impact of Ramadan Fasting on the Reduction of PASI Score, in Moderate-To-Severe Psoriatic Patients: A Real-Life Multicenter Study. Nutrients 2019, 11, 277. https://doi.org/10.3390/nu11020277

AMA Style

Damiani G, Watad A, Bridgewood C, Pigatto PDM, Pacifico A, Malagoli P, Bragazzi NL, Adawi M. The Impact of Ramadan Fasting on the Reduction of PASI Score, in Moderate-To-Severe Psoriatic Patients: A Real-Life Multicenter Study. Nutrients. 2019; 11(2):277. https://doi.org/10.3390/nu11020277

Chicago/Turabian Style

Damiani, Giovanni; Watad, Abdulla; Bridgewood, Charlie; Pigatto, Paolo D.M.; Pacifico, Alessia; Malagoli, Piergiorgio; Bragazzi, Nicola L.; Adawi, Mohammad. 2019. "The Impact of Ramadan Fasting on the Reduction of PASI Score, in Moderate-To-Severe Psoriatic Patients: A Real-Life Multicenter Study" Nutrients 11, no. 2: 277. https://doi.org/10.3390/nu11020277

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