Comparative efficacy of Panchtikta Guggulu Ghrita and Brihat Marichadya Taila with and without diet and lifestyle advocacy in improving clinical outcomes and QoL in psoriasis: A prospective open-label randomized controlled study

BACKGROUND: Psoriasis, a chronic immune-mediated inflammatory skin disorder, manifests as erythematous, scaly patches due to uncontrolled keratinocyte proliferation and dysfunctional differentiation, significantly affecting the quality of life in affected individuals. Owing to its chronic nature, there is a need for accessible, effective, and safe long-term treatments. Ayurveda therapeutic approaches have demonstrated efficacy and safety in managing psoriasis and development of evidence base for the same is required. AIM: To evaluate the safety and efficacy of Panchtikta Guggulu Ghrita and Brihat Marichadya Taila , with diet and lifestyle advocacy in psoriasis. MATERIALS AND METHODS: An open-label, parallel-arm randomized controlled study was conducted at the Regional Ayurveda Research Institute in Gwalior. A total of 120 participants aged 18–60 years, diagnosed with psoriasis, were enrolled from the outpatient department based on predefined selection criteria and were allocated into two groups in a 1:1 ratio. The first group received Panchtiktaguggulu Ghrita (6 gm twice a day orally before meals with lukewarm water) and Brihatmarichyadya Taila (for local application) over an 84-day period. The second group received diet and lifestyle advocacy in addition to the therapeutic interventions. Outcomes assessed were changes in Psoriasis Area and Severity Index (PASI) scores, dermatology life quality Index (DLQI) questionnaires, and clinical signs and symptoms of the disease. Paired t-tests were used to compare mean changes from baseline to the 84th day and further at day 98, without, without intervention. RESULTS: A total of 116 participants were analyzed, with 76.72% males. Both groups showed significant reductions in PASI scores from baseline to day 84, which were sustained at day 98 (Group I: 27.86 ± 13.36–6.70 ± 8.77–5.85 ± 8.98; Group II: 27.92 ± 12.70–9.34 ± 14.15–7.67 ± 11.75; P < 0.001 for within-group changes). DLQI scores also improved significantly in both groups (Group I: 13.74 ± 5.71–3.24 ± 4.16–3.16 ± 4.27; Group II: 13.26 ± 5.03–4.05 ± 5.00–3.12 ± 5.48; P < 0.001). No significant inter-group differences were observed ( P > 0.05). Improvements were sustained at day 98, indicating a persistent remissive effect. CONCLUSION: The combination of Panchtiktaguggulu Ghrita and Brihatmarichyadya taila showcased notable efficacy, safety, and tolerability over the course of an 84-day administration in individuals with psoriasis. CTRI: The trial was registered with CTRI with registration number CTRI/2015/01/005426.