Psoriasis is a chronic immune-mediated inflammatory skin disease that markedly affects physical comfort, mental health, and quality of life. Although systemic therapies and biologics are effective for many patients, concerns about long-term safety, tolerability, and durability persist. This has increased interest in dietary supplements with anti-inflammatory and immunomodulatory effects as adjunctive treatment options. However, comparative evidence across different supplements has remained limited.
To bridge this gap, Danping Chen from the Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China, and colleagues performed a systematic review and network meta-analysis to assess the efficacy and safety of dietary supplements used alongside standard therapy for plaque psoriasis.
The analysis included 21 randomized controlled trials involving 1,463 patients, drawing data from eight international and Chinese databases up to March 3, 2025. Supplements evaluated included vitamin D, XP-828L, fish oil, selenium, probiotics, curcumin, and micronutrients.
Outcomes assessed were changes in PASI, DLQI, and physician global assessment scores, levels of inflammatory cytokines such as IL-6, IL-17, IL-22, and IL-23, and adverse events. A frequentist network meta-analysis was applied, with treatments ranked for efficacy and safety using the surface under the cumulative ranking curve values.
The meta-analysis led to the following findings:
- Vitamin D supplementation was linked to a statistically significant reduction in PASI scores, reflecting an improvement in psoriasis severity.
- XP-828L had the highest likelihood of improving quality-of-life outcomes, including DLQI and PGA scores.
- Vitamin D combined with narrowband UVB therapy consistently reduced inflammatory markers such as IL-6, IL-17, and IL-23.
- Curcumin was particularly effective in lowering IL-22 levels.
- Adverse event rates were similar across all supplement groups and comparable to controls, indicating a favorable safety profile.
Despite these encouraging signals, no single dietary supplement emerged as superior across all clinical and biological outcomes. The authors noted that the certainty of evidence ranged from low to moderate, largely due to heterogeneity among studies, variable dosing regimens, and imprecision in effect estimates.
The findings suggest that dietary supplements may play complementary, rather than universal, roles in psoriasis management. Vitamin D may be more relevant for patients with prominent systemic inflammation, XP-828L for those with quality-of-life–driven concerns, and curcumin for individuals in whom IL-22–related inflammatory pathways are implicated. However, the authors emphasize that these conclusions remain provisional.
"Larger, high-quality randomized trials with standardized supplement formulations, longer follow-up, and clearer patient stratification are needed to confirm comparative effectiveness and support personalized adjunctive treatment strategies in psoriasis," they concluded.
Reference:
Chen, D., Yang, J., Yang, W., Liu, X., & Li, Z. (2025). Effectiveness and safety of dietary supplements in the adjunctive treatment of psoriasis: A systematic review and network meta-analysis. Frontiers in Nutrition, 12, 1718828. https://doi.org/10.3389/fnut.2025.1718828
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