Efficacy of Systemic Treatments of Psoriasis on Pruritus: A Systemic Literature Review and Meta-Analysis

In the course of the last 30 years, several studies have clearly documented that pruritus is a very frequent symptom of psoriasis and its impact on the patients' quality of life. The variety of available systemic treatments for psoriasis is increasing rapidly. Our objective was to assess their efficacy on pruritus based on a systematic literature review. A systematic literature search was performed using PubMed and Trip Database (from January 1990 to September 2016) to find published clinical trials for the treatments of psoriasis, and then a meta-analysis was performed. Among 516 articles identified, 35 studies were retained in the systematic review. At baseline, the high prevalence of pruritus (80-100%) was confirmed. The meta-analysis included 13 trials using a 0 to 10 itch scale and highlighted that all treatments evaluated reduced pruritus. Anti-IL-17, JAK inhibitors, adalimumab, and apremilast were all shown to be effective in reducing pruritus in psoriasis with variable effect size magnitudes. Our systematic review highlights that systemic treatments, including UVB phototherapy, improve pruritus in psoriasis but that it is not necessarily correlated with lesion recovering. Nonetheless, these results must be displayed carefully because there are so many variable endpoints in different studies.