Javier Perez-Bootello, Emilio Berna-Rico, Carlota Abbad-Jaime de Aragon, Leticia Goni, Zenaida Vazquez-Ruiz, Fernando Neria, Ruth Cova-Martin, Jorge Naharro-Rodriguez, Asuncion Ballester-Martinez, Cristina Pindado-Ortega, Diana Monge, Andrew Blauvelt, Pedro Jaen, Nehal Mehta, Joel M Gelfand, Miguel A Martinez-Gonzalez, Álvaro Gonzalez-Cantero
{"title":"地中海饮食和牛皮癣患者：MEDIPSO随机临床试验。","authors":"Javier Perez-Bootello, Emilio Berna-Rico, Carlota Abbad-Jaime de Aragon, Leticia Goni, Zenaida Vazquez-Ruiz, Fernando Neria, Ruth Cova-Martin, Jorge Naharro-Rodriguez, Asuncion Ballester-Martinez, Cristina Pindado-Ortega, Diana Monge, Andrew Blauvelt, Pedro Jaen, Nehal Mehta, Joel M Gelfand, Miguel A Martinez-Gonzalez, Álvaro Gonzalez-Cantero","doi":"10.1001/jamadermatol.2025.3410","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Despite growing interest on the role of diet in the prevention and treatment of psoriasis, randomized clinical trials are lacking. The Mediterranean diet is known for its anti-inflammatory and cardiometabolic benefits, which may be relevant to psoriasis pathophysiology.</p><p><strong>Objective: </strong>To assess whether a 16-week Mediterranean diet intervention would improve psoriasis severity in patients with mild to moderate disease.</p><p><strong>Design, setting, and participants: </strong>MEDIPSO (Impact of the Mediterranean Diet on Patients With Psoriasis), an open-label, single-center, single-blinded (evaluator) randomized clinical trial, was conducted from February 2024 to March 2025 at a dermatology referral clinic in Madrid, Spain. Participants were adults with mild to moderate psoriasis (Psoriasis Area and Severity Index [PASI] of 2-10, with higher scores indicating maximal disease) receiving stable topical therapy.</p><p><strong>Interventions: </strong>Participants were randomized 1:1 to the intervention or control group. The intervention group received a 16-week, dietitian-guided Mediterranean diet program, including nutritional counseling, educational materials, and weekly provision of extra virgin olive oil. The control group received standard low-fat dietary advice without dietitian supervision.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the change in the PASI from baseline to week 16. Secondary outcomes included changes in Mediterranean diet adherence, anthropometric and metabolic parameters, serum inflammatory cytokines, and patient-reported outcomes. Estimated marginal means (EMMs) at baseline and for the change from baseline to week 16 were reported, with the intervention effect presented as the between-group difference.</p><p><strong>Results: </strong>Among 45 individuals screened, 38 participants were enrolled and randomized (mean [SD] age, 46.4 [12.8] years; 25 males [65.8%]); 19 were randomized to the intervention group and 19 were randomized to the control group; 37 individuals (97.4%) completed the study. The EMM PASI change at week 16 was -3.4 (95% CI, -4.4 to -2.4) in the intervention group and 0.0 (95% CI, -1.0 to 1.0) in the control group; the between-group EMM difference was -3.4 (95% CI, -4.8 to -2.0; P < .001). Nine of 19 participants in the Mediterranean diet group (47.4%) achieved PASI 75 (a 75% reduction in PASI) compared with none in the control group. A significant reduction in EMM hemoglobin A1c (glycated hemoglobin) was observed in the intervention group as compared with the control group (between-group EMM difference, -4.1 mmol/mol [95% CI, -6.9 to -1.3 mmol/mol]; P = .01).</p><p><strong>Conclusions and relevance: </strong>This randomized clinical trial found that a 16-week Mediterranean diet intervention significantly improved psoriasis severity in patients with mild to moderate disease receiving stable topical therapy. These findings suggest that incorporating dietary strategies may be beneficial as an adjunctive therapy in psoriasis management.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06257641.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":""},"PeriodicalIF":11.0000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461594/pdf/","citationCount":"0","resultStr":"{\"title\":\"Mediterranean Diet and Patients With Psoriasis: The MEDIPSO Randomized Clinical Trial.\",\"authors\":\"Javier Perez-Bootello, Emilio Berna-Rico, Carlota Abbad-Jaime de Aragon, Leticia Goni, Zenaida Vazquez-Ruiz, Fernando Neria, Ruth Cova-Martin, Jorge Naharro-Rodriguez, Asuncion Ballester-Martinez, Cristina Pindado-Ortega, Diana Monge, Andrew Blauvelt, Pedro Jaen, Nehal Mehta, Joel M Gelfand, Miguel A Martinez-Gonzalez, Álvaro Gonzalez-Cantero\",\"doi\":\"10.1001/jamadermatol.2025.3410\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>Despite growing interest on the role of diet in the prevention and treatment of psoriasis, randomized clinical trials are lacking. The Mediterranean diet is known for its anti-inflammatory and cardiometabolic benefits, which may be relevant to psoriasis pathophysiology.</p><p><strong>Objective: </strong>To assess whether a 16-week Mediterranean diet intervention would improve psoriasis severity in patients with mild to moderate disease.</p><p><strong>Design, setting, and participants: </strong>MEDIPSO (Impact of the Mediterranean Diet on Patients With Psoriasis), an open-label, single-center, single-blinded (evaluator) randomized clinical trial, was conducted from February 2024 to March 2025 at a dermatology referral clinic in Madrid, Spain. Participants were adults with mild to moderate psoriasis (Psoriasis Area and Severity Index [PASI] of 2-10, with higher scores indicating maximal disease) receiving stable topical therapy.</p><p><strong>Interventions: </strong>Participants were randomized 1:1 to the intervention or control group. The intervention group received a 16-week, dietitian-guided Mediterranean diet program, including nutritional counseling, educational materials, and weekly provision of extra virgin olive oil. The control group received standard low-fat dietary advice without dietitian supervision.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the change in the PASI from baseline to week 16. Secondary outcomes included changes in Mediterranean diet adherence, anthropometric and metabolic parameters, serum inflammatory cytokines, and patient-reported outcomes. Estimated marginal means (EMMs) at baseline and for the change from baseline to week 16 were reported, with the intervention effect presented as the between-group difference.</p><p><strong>Results: </strong>Among 45 individuals screened, 38 participants were enrolled and randomized (mean [SD] age, 46.4 [12.8] years; 25 males [65.8%]); 19 were randomized to the intervention group and 19 were randomized to the control group; 37 individuals (97.4%) completed the study. The EMM PASI change at week 16 was -3.4 (95% CI, -4.4 to -2.4) in the intervention group and 0.0 (95% CI, -1.0 to 1.0) in the control group; the between-group EMM difference was -3.4 (95% CI, -4.8 to -2.0; P < .001). Nine of 19 participants in the Mediterranean diet group (47.4%) achieved PASI 75 (a 75% reduction in PASI) compared with none in the control group. 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Mediterranean Diet and Patients With Psoriasis: The MEDIPSO Randomized Clinical Trial.
Importance: Despite growing interest on the role of diet in the prevention and treatment of psoriasis, randomized clinical trials are lacking. The Mediterranean diet is known for its anti-inflammatory and cardiometabolic benefits, which may be relevant to psoriasis pathophysiology.
Objective: To assess whether a 16-week Mediterranean diet intervention would improve psoriasis severity in patients with mild to moderate disease.
Design, setting, and participants: MEDIPSO (Impact of the Mediterranean Diet on Patients With Psoriasis), an open-label, single-center, single-blinded (evaluator) randomized clinical trial, was conducted from February 2024 to March 2025 at a dermatology referral clinic in Madrid, Spain. Participants were adults with mild to moderate psoriasis (Psoriasis Area and Severity Index [PASI] of 2-10, with higher scores indicating maximal disease) receiving stable topical therapy.
Interventions: Participants were randomized 1:1 to the intervention or control group. The intervention group received a 16-week, dietitian-guided Mediterranean diet program, including nutritional counseling, educational materials, and weekly provision of extra virgin olive oil. The control group received standard low-fat dietary advice without dietitian supervision.
Main outcomes and measures: The primary outcome was the change in the PASI from baseline to week 16. Secondary outcomes included changes in Mediterranean diet adherence, anthropometric and metabolic parameters, serum inflammatory cytokines, and patient-reported outcomes. Estimated marginal means (EMMs) at baseline and for the change from baseline to week 16 were reported, with the intervention effect presented as the between-group difference.
Results: Among 45 individuals screened, 38 participants were enrolled and randomized (mean [SD] age, 46.4 [12.8] years; 25 males [65.8%]); 19 were randomized to the intervention group and 19 were randomized to the control group; 37 individuals (97.4%) completed the study. The EMM PASI change at week 16 was -3.4 (95% CI, -4.4 to -2.4) in the intervention group and 0.0 (95% CI, -1.0 to 1.0) in the control group; the between-group EMM difference was -3.4 (95% CI, -4.8 to -2.0; P < .001). Nine of 19 participants in the Mediterranean diet group (47.4%) achieved PASI 75 (a 75% reduction in PASI) compared with none in the control group. A significant reduction in EMM hemoglobin A1c (glycated hemoglobin) was observed in the intervention group as compared with the control group (between-group EMM difference, -4.1 mmol/mol [95% CI, -6.9 to -1.3 mmol/mol]; P = .01).
Conclusions and relevance: This randomized clinical trial found that a 16-week Mediterranean diet intervention significantly improved psoriasis severity in patients with mild to moderate disease receiving stable topical therapy. These findings suggest that incorporating dietary strategies may be beneficial as an adjunctive therapy in psoriasis management.
期刊介绍：
JAMA Dermatology is an international peer-reviewed journal that has been in continuous publication since 1882. It began publication by the American Medical Association in 1920 as Archives of Dermatology and Syphilology. The journal publishes material that helps in the development and testing of the effectiveness of diagnosis and treatment in medical and surgical dermatology, pediatric and geriatric dermatology, and oncologic and aesthetic dermatologic surgery.
JAMA Dermatology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications. It is published online weekly, every Wednesday, and in 12 print/online issues a year. The mission of the journal is to elevate the art and science of health and diseases of skin, hair, nails, and mucous membranes, and their treatment, with the aim of enabling dermatologists to deliver evidence-based, high-value medical and surgical dermatologic care.
The journal publishes a broad range of innovative studies and trials that shift research and clinical practice paradigms, expand the understanding of the burden of dermatologic diseases and key outcomes, improve the practice of dermatology, and ensure equitable care to all patients. It also features research and opinion examining ethical, moral, socioeconomic, educational, and political issues relevant to dermatologists, aiming to enable ongoing improvement to the workforce, scope of practice, and the training of future dermatologists.
JAMA Dermatology aims to be a leader in developing initiatives to improve diversity, equity, and inclusion within the specialty and within dermatology medical publishing.
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