Effect of Biological Treatment on Fatigue in Psoriasis: A Systematic Review and Meta-Analysis

Background Fatigue is frequent in patients with psoriasis. Though conventional drugs in general have no effect on fatigue, biological agents have demonstrated beneficial effects in several other chronic inflammatory diseases. Objective The objective of the present study was to evaluate the effect of biological drugs on fatigue in patients with psoriasis vulgaris. Methods We conducted a meta-analysis of randomized controlled trials in which anti-interleukin-12/23, anti-interleukin-23, anti-interleukin-17, or anti-tumor necrosis factor-alpha agents were used for psoriasis vulgaris and fatigue was an outcome measure. Results A total of eight randomized controlled trials fulfilled criteria for inclusion in the meta-analysis. The studies used two fatigue reporting scales: the Functional Assessment of Chronic Illness Therapy-Fatigue and the Short Form 36 Health Survey Vitality Subscale. Treatment by biological agents in general compared with placebo led to a significant reduction in fatigue, with a standardized mean difference of - 0.40 (95% confidence interval - 0.46 to - 0.34; p < 0.001). Conclusion Biological drugs used for the treatment of psoriasis vulgaris have a consistently small-to-moderate beneficial effect on fatigue independent of the type of drug.