Acta Dermato-Venereologica 99-10CompleteContent | Page 19
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