SYSTEMATIC REVIEW article
Front. Nutr.
Sec. Clinical Nutrition
Effectiveness and Safety of Dietary Supplements in the Adjunctive Treatment of Psoriasis: A Systematic Review and Network Meta-analysis
Provisionally accepted
- 1Heilongjiang University of Chinese Medicine, Harbin, China
- 2The Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China, 哈尔滨市, China
- 3Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Background: Psoriasis, a chronic immune-mediated inflammatory skin disease, significantly impairs quality of life. Conventional treatments often pose safety risks or lack long-term efficacy. Dietary supplements show immunomodulatory and anti-inflammatory effects, but their adjunctive role in plaque psoriasis lacks comprehensive comparison. Methods: A network meta-analysis (NMA) of 21 randomized controlled trials (RCTs), involving 1,463 patients with plaque psoriasis, was conducted using eight international and Chinese databases up to March 3, 2025. Interventions included vitamin D, XP-828L, fish oil, selenium, probiotics, curcumin, and micronutrients. Primary outcomes were Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), Physician Global Assessment (PGA), interleukins (IL-6, IL-17, IL-23, IL-22), and adverse events. A frequentist NMA in Stata 17.0 used surface under the cumulative ranking curve (SUCRA) to rank efficacy and safety. Results: In 21 RCTs (n = 1,463), Vitamin D supplementation significantly reduced PASI scores (MD = −3.29, 95% CI −6.38 to −0.20). XP-828L showed the highest probability of improving DLQI/PGA, and vitamin D+NB-UVB most consistently lowered IL-6/IL-17/IL-23; curcumin reduced IL-22. Adverse events were comparable across interventions (RR 1.02, 95% CI 0.94–1.10). No supplement dominated across all outcomes, and overall certainty was low-to-moderate due to heterogeneity and imprecision. Conclusions: Dietary supplements may provide complementary benefits in plaque psoriasis; however, effect estimates vary by outcome and certainty is low-to-moderate. Personalization is advisable, and confirmatory, larger RCTs with standardized dosing and longer follow-up are warranted. (Word count: 223)
Keywords: Psoriasis, Dietary Supplements, Vitamin D, XP-828L, Curcumin, Network meta-analysis, Systematic review, Interleukins
Received: 04 Oct 2025; Accepted: 18 Nov 2025.
Copyright: © 2025 Chen, Yang, Yang, Liu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhihong Li, vipzhihong@163.com
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