Adding Intermittent Fasting to Methotrexate Nearly Doubles Psoriasis Remission: What the Research Shows

Adding Intermittent Fasting to Methotrexate Nearly Doubles Psoriasis Remission: What the Research Shows

Medical disclaimer: This article summarises published research for informational purposes only. It is not medical advice and is not a substitute for guidance from a qualified health professional. Always consult your doctor before starting any fasting protocol, especially if you have an existing health condition or take medication.

Study at a Glance

What This Study Looked At

Researchers wanted to know whether adding a simple 16:8 intermittent fasting protocol to standard methotrexate treatment could improve outcomes for people with chronic plaque psoriasis, a condition that often requires long-term systemic drug therapy to keep symptoms in remission. This adds a helpful data point to the broader picture of fasting and inflammation, since psoriasis is fundamentally an inflammatory skin condition. It also builds on earlier findings about fasting and skin conditions that were historically observed long before modern trials existed.

Who Was Studied

Participant profile: Adults with chronic plaque psoriasis eligible for systemic methotrexate therapy, randomized into two equal-sized parallel groups.

How the fasting protocol worked in this study: Participants in the fasting group followed a 16:8 schedule — fasting for 16 hours each day and eating within an 8-hour window — alongside their regular methotrexate dosing, with no other prescribed dietary restrictions.

What the Researchers Found

Psoriasis Severity (PASI50 Remission)

• At 16 weeks, both groups showed similar rates of achieving PASI50 (at least a 50% improvement in psoriasis severity), with no statistically significant difference (p = 0.8)
• By 28 weeks, the fasting group maintained remission at nearly 1.5 times the rate of the methotrexate-only group (54.4% vs 36%), a difference that approached statistical significance (p = 0.054)
• The key finding: intermittent fasting appears to help sustain psoriasis remission over time, even when initial response rates are similar between groups

Inflammatory and Vascular Markers

• High-sensitivity C-reactive protein (hsCRP) was significantly reduced in the fasting group compared to methotrexate alone
• Vascular endothelial growth factor (VEGF), a marker linked to the abnormal blood vessel growth seen in psoriatic skin, was significantly reduced in the fasting group
• Interleukin-6 (IL-6), a key inflammatory cytokine involved in psoriasis, was also significantly reduced in the fasting group

Metabolic Parameters

• Fasting and postprandial blood sugar improved in the group combining methotrexate with intermittent fasting
• Lipid profile measures also showed improvement alongside the metabolic changes

What Did Not Change

• Early response rates (PASI50 at 16 weeks) were not significantly different between groups — the benefit of fasting emerged mainly in sustaining remission over the longer term
• The trial did not report any indication of reduced muscle or lean mass, since this was not a weight-loss-focused intervention

What the Researchers Concluded

The study authors concluded that 16:8 intermittent fasting is an easy-to-follow, safe, and effective adjuvant to methotrexate for managing chronic plaque psoriasis, helping patients maintain remission for longer while also improving metabolic health and markers of vascular inflammation.

What This Means If You Fast

• Fasting may support, not replace, medical treatment: This study adds fasting on top of methotrexate rather than instead of it — it's a complementary approach, not a substitute for prescribed psoriasis treatment.
• The benefit shows up over time: The two groups looked similar at 16 weeks, but the fasting group pulled ahead by 28 weeks, suggesting the advantage of intermittent fasting may be about long-term remission rather than a quick fix. This echoes what historical fasting cases with skin conditions reported anecdotally over a century ago.
• 16:8 is an accessible starting point: Unlike prolonged multi-day fasting protocols used in some inflammation research, this trial used a straightforward daily 16:8 window, which may be easier for people already managing a chronic condition and medication schedule.
• Inflammatory markers moved in the right direction: Reductions in hsCRP, VEGF, and IL-6 line up with what's known about how fasting affects inflammation more broadly.
• Anyone with psoriasis on methotrexate should talk to their dermatologist first: Fasting alongside a systemic medication should be supervised, particularly around dosing schedules and monitoring liver and blood sugar parameters.

Study Limitations

• Sample size (n=120) is reasonable for a Phase IIb trial but still relatively modest for drawing definitive conclusions
• The difference in the primary PASI50 outcome at 28 weeks did not reach the conventional statistical significance threshold (p = 0.054)
• The trial was conducted in a single country/population, which may limit how well findings generalize to other populations
• Fasting adherence was not independently verified through objective tracking, relying instead on patient self-report
• Funding source was not reported in the available abstract

Source

Neema, S., et al. (2025). Efficacy of Intermittent Fasting in the Management of Chronic Plaque Psoriasis: A Phase IIb Clinical Trial. Indian Dermatology Online Journal. PMID: 40395583

Frequently Asked Questions

Does intermittent fasting help with psoriasis?

This 2025 trial found that adding 16:8 intermittent fasting to methotrexate treatment nearly doubled the rate of sustained remission at 28 weeks (54.4% vs 36%) compared to methotrexate alone, though the difference was borderline statistically significant.

Can intermittent fasting replace methotrexate for psoriasis?

No. This study tested fasting as an add-on to methotrexate, not as a replacement. All participants continued their prescribed methotrexate dose throughout the trial.

What fasting schedule was used in the psoriasis study?

Participants followed a 16:8 intermittent fasting protocol — a 16-hour fasting period followed by an 8-hour eating window each day — with no other specific dietary restrictions reported.

Did fasting reduce inflammation markers in people with psoriasis?

Yes. The fasting group showed significant reductions in hsCRP, VEGF, and IL-6 compared to the methotrexate-only group, all markers associated with inflammation and the abnormal blood vessel growth seen in psoriatic plaques.

How long did it take to see a difference between the fasting and non-fasting groups?

The two groups had similar remission rates at 16 weeks, but the fasting group's advantage became clearer by 28 weeks, suggesting the benefits of fasting may build gradually rather than appear immediately.

Related Research and Articles

• Fasting and Skin Conditions: Why Eczema and Catarrh Were Among the First Targets
• Fasting and Inflammation: What Women Should Know
• Intermittent Fasting and Autoimmune Conditions in Women
• Fasting and Rheumatism: What 277 Historical Cases Showed
• Intermittent Fasting and Joint Pain in Women

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