Dietary Supplements Aid in Psoriasis Treatment, Though Effect Estimates Vary

Curcumin, vitamin D, and XP-828L appear to be the most promising dietary supplements for addressing psoriasis based on mechanistic plausibility, directional consistency, and favorable tolerability, new data suggest.1

These results and others were drawn from a network meta-analysis (NMA) written to assess and rank the effectiveness and safety of various dietary supplements in patients with psoriasis. The data, authored by such investigators as Danping Chen, MD, of Heilongjiang University of Chinese Medicine, highlighted several potential adjunctive options for patients prior to evaluation.

These supplements included vitamin D, omega-3 fatty acids, probiotics, selenium, curcumin, micronutrients, and XP-828L. Typical psoriasis treatment modalities, Chen et al noted, carry adverse effects, as well as adherence considerations and limited drug survival in routine practice.2

“Unlike earlier reviews limited to single supplements or pairwise comparisons, this study jointly evaluates multiple supplements and outcomes in a coherent framework,” Chen and colleagues said.1 “The objective is to conduct an NMA comparing and ranking the effectiveness and safety of dietary supplements as adjunctive therapy for plaque psoriasis.”

Network Meta-Analysis Details

The investigative team set out to conduct an NMA that would compare and rank adjunctive dietary supplements for plaque psoriasis by safety and efficacy, with the team integrating both direct and indirect evidence from Chinese- and English-language sources. Chen and colleagues' aim was to generate clinically meaningful effect estimates with quantified uncertainty that could support individualized treatment decisions on supplement use.

A set of 8 databases, including China National Knowledge Infrastructure (CNKI), WanFang, VIP Chinese Science and Technology Journal Database, Cochrane Library, PubMed, SinoMed, Embase, and Web of Science, were searched by 2 investigators from the time of database inception through March 2025. The investigators' strategy involved the use of the term “psoriasis” alongside an extensive array of keywords which were supplement-related. Such keywords included minerals, nutritional, food, herbal supplements, vitamins, folic acid, probiotics, coenzyme Q10, fish oil, amino acids, cherry extract, turmeric, and celery seed extract.

Assessment of risk of bias for included research was done via the Cochrane Risk of Bias 2 (RoB 2) tool, which examines 5 methodological domains: the randomization process, completeness of outcome data, deviations from intended interventions, outcome measurement, and selective reporting. Each domain was classified by Chen and coauthors as lower risk, some concerns, or high risk. 21 randomized controlled trials (RCTs), encompassing a total of 1463 patients with psoriasis, were shown by the investigators to have met the necessary criteria to be included in the NMA. The interventions evaluated across these RCTs included XP-828L, vitamin D, fish oil, probiotics, selenium, curcumin, and diifferent micronutrient formulations.

In their evaluation of primary outcomes, Chen et al looked into any shifts in Dermatology Life Quality Index (DLQI), Psoriasis Area and Severity Index (PASI), physician global assessment (PGA), the incidence of adverse events (AEs), and inflammatory biomarkers [interleukin (IL)-6, IL-17, IL-23, and IL-22]. A frequentist NMA was conducted by the investigators using Stata version 17.0. They generated supplement rankings via the surface under the cumulative ranking curve (SUCRA).

Findings on Dietary Supplements for Psoriasis

Across these 21 RCTs, supplementation with vitamin D was linked with a statistically significant PASI score reduction, with a mean difference of −3.29 (95% CI, −6.38 to −0.20). Additionally, the investigative team found XP-828L showed the highest probability of DLQI and PGA score outcome improvements. The use of vitamin D alongside narrowband ultraviolet B (NB-UVB) therapy was shown to have the most consistent IL-6, IL-17, and IL-23 level reductions among patients. The team also pointed to a link between curcumin and decreases in levels of IL-22.

There was not a meaningful distinction between AE rates in the different interventions, with a pooled risk ratio of 1.02 (95% CI, 0.94–1.10). There was no single supplement shown by Chen and coauthors to have emerged as superior across all measured outcomes. The overall certainty of evidence was determined to be low to moderate, and this was largely due to heterogeneity and imprecision.

These data support a personalized approach to psoriasis treatment supplementation. The findings underscore the importance of additional, larger, and well-designed RCTs with standardized dosing regimens as well as longer follow-up periods.

“No single dietary supplement optimally addresses all indicators in plaque psoriasis,” Chen et al concluded.1 “This NMA (21 RCTs) highlights the differential roles of key supplements: Patterns observed across supplements suggest complementary roles: vitamin D appears more relevant to systemic inflammation, XP-828L to quality-of-life domains, and curcumin to IL-22-linked inflammatory pathways.”

References

1. Chen D, Yang J, Li Z, et al. Effectiveness and safety of dietary supplements in the adjunctive treatment of psoriasis: a systematic review and network meta-analysis. Front Nutr. 2025 Dec 11;12:1718828. doi: 10.3389/fnut.2025.1718828. PMID: 41459063; PMCID: PMC12738169.

2. Shi YL. Interpretation of the Chinese psoriasis guidelines (2023 edition). J Tongji Univ (Med Sci). (2023) 44:631–3.