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907 SHORT COMMUNICATION Effect of Omega-3 Supplementation on Quality of Life in Patients with Psoriasis: A Digital Survey- based Study Anders D. ANDERSEN, Alexander ALMEGAARD, Anders Nikolai ØRSTED SCHULTZ and John Robert ZIBERT LEO Innovation Lab, Silkegade 8, DK-1113 Copenhagen, Denmark. E-mail: [email protected] Accepted May 9, 2019; E-published May 10, 2019 Psoriasis is a chronic inflammatory skin disease that affects approximately 2% of people worldwide, with a reported prevalence as high as 11.4% in western countries (1–3). Living with psoriasis increases the risk of comorbidities, such as atrial fibrillation and stroke, and can also have a detrimental impact on mental health (4, 5). Although novel medical treatments for psoriasis have been widely investigated, there is little information on the influence of diet in people with psoriasis, and the value of specific anti-inflammatory nutrients, such as the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Both EPA and DHA have been repeatedly demonstrated to reduce the risk of inflammatory-mediated diseases, such as diseases of the cardiovascular system (6, 7), partly through direct dampening of the inflammatory tone via effects on the eicosanoids family. We hypothesize that, in people with psoriasis, this effect could impact on how the disease influences patients’ quality of life (QoL). The aims of this study were: (i) to explore the fea- sibility of conducting a fully digital qualitative survey using only e-mails and text messages as the means of communication; and (ii) to explore the effect of fish-oil supplementation (which is rich in omega-3 fatty acids) in people with psoriasis, using Skindex-16, a validated questionnaire for measurement of QoL in patients with skin diseases, as an outcome measure (8). For baseline characteristics χ 2 or one-way analysis of variance (ANOVA) test was performed, as appropriate. For the Skindex-16 a one-way ANOVA test with repeated measurements was used. When ANOVA was used, normality checks and Levene’s test were performed and the assumptions met. For all tests, p < 0.05 was con- sidered statistically significant. With an expected drop-out of up to 25%, we recruited 65 subjects, to get 50 completing participants. RESULTS Four hundred and seventy people applied to participate in the survey. A total of 65 people were included. Of these, 58 (89%) completed the study (Table SI 1 ). Enrolled participants were categorized as having mild (15.5%), moderate (39.6%), or severe (44.8%) psoriasis, according to their self-estimated body coverage of affected skin. https://www.medicaljournals.se/acta/content/abstract/10.2340/00015555-3215 1 METHODS A cohort survey was conducted over a period of 12 weeks. ’Parti- cipants were recruited in Canada using a digital platform (https:// studiesandme.com/, Denmark), and pre-screened with online questionnaires. Inclusion criteria were: diagnosis of psoriasis by a medical doctor and age > 18 years. Exclusion criteria were: body mass index (BMI) > 50 kg/m 2 , systemic drug use, use of blood-thinning medication, diabetes, pregnancy, iodine allergy, or people waiting for surgery. All participants provided written consent to participate in the study. The study was evaluated by the Danish ethics committee (protocol 16025688) and evaluated as a service evaluation, not a clinical study. Participants were classified as having mild (< 3%), moderate (3–10%) or severe (> 10%) psoriasis, based on self-estimated body surface area (BSA) (9). All participants agreed to take 3 capsules of fish-oil/day (PurePharma, Copenhagen, Denmark), equivalent to 2,700 mg fish-oil (1,250 mg EPA and 500 mg DHA), as recommen- ded by the manufacturer’s instructions, for a period of 12 weeks. Participants were asked to complete the Skindex-16 questionnaire at baseline, after 4, 8 and 12 weeks. Participants were reminded to complete the questionnaire by e-mail and text message. Fig. 1. (a) Skindex-16 scores for the 58 completing participants during the course of the study, showing a reduction in the total score from baseline to the end of the study. (b) Skindex-16 in self-reported body surface area (BSA) during the course of the study, showing that total Skindex-16 score for participants classified as moderate or severe improved from baseline to the end of the study. This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica. doi: 10.2340/00015555-3215 Acta Derm Venereol 2019; 99: 907–908