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PsoriasisNCT06242847

Role of Insulin Action in Psoriasis Pathogenesis

An observational study of Psoriasis and Plaque Psoriasis, run by Columbia University at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The goal of this study is to collect more information from people with plaque psoriasis and to determine if insulin plays a role in the pathogenesis of psoriasis. The main question it aims to answer is if insulin action is preserved or even enhanced in psoriatic lesions despite insulin resistance elsewhere. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Psoriasis, Plaque Psoriasis, Insulin Resistance
What is being tested?
Oral glucose tolerance test (OGTT) and Skin punch biopsy
How many people
10 participants
Where
1 siteUnited States
Study dates
2 Feb 2024to 12 Nov 2025
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients with plaque psoriasis but without diabetes mellitus

Who may be able to join

  • Body mass index of 25.0-40.0 kg/m2
  • Able to understand written and spoken English and/or Spanish
  • Written informed consent (in English or Spanish) and any locally required authorization (e.g., Health Insurance Portability and Accountability Act) obtained from the participant prior to performing any protocol-related procedures, including screening evaluations.
  • Diagnosed with plaque psoriasis, documented using Psoriasis Area and Severity Index (PASI)
  • Glucose metabolism status as follows (determined only retrospectively based on data collected during the study):
  • For Insulin Sensitive (IS) group:
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  • Hemoglobin A1c < 5.7%, and
  • Fasting plasma glucose < 95 mg/dL, and
  • Fasting plasma insulin < 10 μIU/mL, and
  • 2-hour post-challenge glucose < 140 mg/dL
  • For Insulin Intermediate (II) group:
  • Hemoglobin A1c < 6.5%, and
  • Fasting plasma glucose 80-125 mg/dL, and
  • Fasting plasma insulin < 15 μIU/mL, and
  • 2-hour post-challenge glucose < 200 mg/dL, and
  • Not otherwise meeting all criteria for the IS group
  • For Insulin Resistant (IR) group:
  • Hemoglobin A1c < 6.5%, and
  • Fasting plasma glucose 80-125 mg/dL, and
  • Fasting plasma insulin ≥ 15 μIU/mL, and
  • 2-hour post-challenge glucose < 200 mg/dL
  • NOTE: Group assignments will be made retroactively, after observational data has been collected. Those not fitting into any of these groups will have their data excluded from further analysis.

Who cannot join

  • Inability to provide informed consent in English or Spanish
  • Laboratory evidence of diabetes mellitus, either determined during the study or based on previous documentation:
  • Hemoglobin A1c ≥ 6.5%, and/or
  • Fasting plasma glucose ≥ 126 mg/dL
  • Plasma glucose ≥ 200 mg/dL at 2 hours after ingestion of a 75-g oral glucose load
  • Random plasma glucose ≥ 200 mg/dL associated with typical hyperglycemic symptoms, diabetic ketoacidosis, or hyperglycemic-hyperosmolar state
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  • History of gestational diabetes mellitus
  • Use of antidiabetic medications within the 90 days prior to screening, including those prescribed for other indications (e.g., weight control, restoration of ovulation in of polycystic ovarian syndrome), including:
  • Metformin, thiazolidinediones, sulfonylureas, meglitinides, dipeptidyl peptidase-4 (DPP4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, sodium/glucose cotransporter 2 (SGLT2) inhibitors, amylin mimetics, acarbose, insulin
  • Clinical concern for absolute insulin deficiency (e.g., type 1 diabetes, pancreatic disease)
  • Reproductive concerns
  • Women of childbearing potential not using highly effective contraception, defined as:
  • Surgical sterilization (e.g., bilateral tubal occlusion, bilateral oophorectomy and/or salpingectomy, hysterectomy)
  • Combined oral contraceptive pills taken daily, including during the study
  • Intrauterine device (levonorgestrel-eluting or copper) active at the time of the study
  • Medroxyprogesterone acetate (Depo-Provera®) injection active at the time of the study
  • Etonogestrel implants (e.g., Implanon®, etc.) active at the time of the study
  • Norelgestromin/ethinyl estradiol transdermal system (e.g., Ortho-Evra®) active at the time of the study NOTE: Women not using any of the above forms of birth control may be included if they have a negative urine pregnancy test on the day of the study, before beginning any study procedures.
  • Women currently pregnant
  • Women currently breastfeeding
  • Known, documented history, at the time of screening, of any of the following medical conditions:
  • Bleeding disorders, including due to anticoagulation or use of P2Y12 inhibitors ii. Anemia requiring treatment iii. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Use of medications associated methemoglobinemia within 48 hours of shave biopsy procedures:
  • Nitrates/nitrites: nitric oxide, nitroglycerin, nitroprusside, nitrous oxide ii. Antineoplastics: cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase iii. Antibiotics: dapsone, nitrofurantoin, paraaminosalicylic acid, sulfonamides iv. Antimalarials: chloroquine, primaquine v. Anticonvulsants: phenobarbital, phenytoin, valproic acid vi. Others: acetaminophen, metoclopramide, quinine, sulfasalazine
  • History of severe infection or ongoing febrile illness within 30 days of screening
  • Any other disease, condition, or laboratory value that, in the opinion of the investigator, would place the participant at an unacceptable risk and/or interfere with the analysis of study data.
  • 13. Known allergy/hypersensitivity to any component of the medicinal product formulations (including amide anesthetics), IV infusion equipment, plastics, adhesive or silicone, history of infusion site reactions with IV administration of other medicines, or ongoing clinically important allergy/hypersensitivity as judged by the investigator.
  • 14. Concurrent enrollment in another clinical study of any investigational drug therapy within 6 months prior to screening or within 5 half-lives of an investigational agent, whichever is longer.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Columbia University Irving Medical Center

    New York, New York, 10032

Other trials in United States

About this study

The goal of this study is to collect more information from people with plaque psoriasis and to determine if insulin plays a role in the pathogenesis of psoriasis. The main question it aims to answer is if insulin action is preserved or even enhanced in psoriatic lesions despite insulin resistance elsewhere. Participants with plaque psoriasis will have punch biopsies taken of lesional and non-lesional skin after an overnight fast and then during an oral glucose tolerance test. Biopsy specimens will then be assessed for markers of insulin action.

Read the detailed description

Psoriasis exhibits a clear and robust epidemiologic association with type 2 diabetes mellitus (T2DM). Although T2DM may exacerbate psoriasis and/or complicate its treatment, we do not understand the mechanisms connecting them. As a starting point, psoriasis appears to worsen the insulin resistance (IR) that underlies T2DM. The study investigators hypothesize that the hyperinsulinemia that attempts to compensate for IR retains the ability to drive proliferation of psoriatic lesions. This would set up a vicious cycle in which psoriasis worsens IR, which in turn stimulates insulin hypersecretion that further intensifies psoriasis. In order to test this hypothesis, the investigators must first determine if insulin signaling in psoriatic lesions is actually hyperactive. The investigators therefore propose in this pilot study to elucidate the nature of insulin signaling in psoriasis by measuring phosphorylation of AKT, insulin's key intracellular signaling mediator, in skin biopsies. We will perform shave punch biopsies of lesional and non-lesional skin in overnight-fasted patients with psoriasis who are overweight or obese and therefore at risk of IR. Another set of biopsies will be taken during an oral glucose tolerance test that stimulates endogenous insulin secretion. The investigators expect that AKT phosphorylation will be attenuated in non-lesional skin of patients determined to have IR compared to those who are Insulin Sensitive (IS) or Insulin Intermediate (II), but that AKT phosphorylation will be preserved or even enhanced in lesional skin despite IR. Determining that insulin action is excessive in psoriatic lesions would suggest reducing insulin levels as a novel psoriasis treatment strategy that would also help to spare patients from difficult immunomodulatory treatments.

Being tested
Oral glucose tolerance test (OGTT), Skin punch biopsy
Keywords
Insulin, Insulin resistance, Psoriasis
Medical subject headings
Psoriasis, Insulin Resistance, Prediabetic State, Overweight, Obesity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Oral glucose tolerance test (OGTT)Diagnostic test

    Participants ingest 75 g of glucose in 10 fl oz aqueous solution (fruit flavored) after an overnight fast. Blood is drawn at baseline (t = 0 min) and at 120 min after ingestion. This test is non-experimental.

  • Skin punch biopsyProcedure or surgery

    Punch biopsies are taken from lesional (psoriatic) and non-lesional skin after an overnight fast and at 120 min after ingestion of glucose during OGTT. This procedure is non-experimental.

Study groups in NCT06242847
Study groupRoleWhat they receive
Insulin Sensitive (IS) with psoriasisPatients with plaque psoriasis found to have: * Hemoglobin A1c < 5.7% * Fasting plasma glucose: < 95 mg/dL * Fasting serum insulin: < 10 micro-international units per milliliter (μIU/mL) * 2-hour post-challenge glucose < 140 mg/dL NOTE: Group assignments made retroactively based on the observational study results.
Receives: Diagnostic Test: Oral glucose tolerance test (OGTT); Procedure: Skin punch biopsy
Insulin Intermediate (II) with psoriasisPatients with plaque psoriasis found to have: * Hemoglobin A1c < 6.5% * Fasting plasma glucose <125 mg/dL * Fasting serum insulin: <15 μIU/mL * 2-hour post-challenge glucose < 200 mg/dL NOTE: Group assignments made retroactively based on the observational study results. • Not otherwise meeting all criteria for inclusion in the IS group
Receives: Diagnostic Test: Oral glucose tolerance test (OGTT); Procedure: Skin punch biopsy
Insulin Resistant (IR) with psoriasisPatients with plaque psoriasis found to have: * Fasting serum/plasma insulin ≥ 15 μIU/mL * Fasting plasma glucose 80-125 mg/dL and * Hemoglobin A1c < 6.5% and * 2-hour post-challenge glucose < 200 mg/dL NOTE: Group assignments made retroactively based on the observational study results.
Receives: Diagnostic Test: Oral glucose tolerance test (OGTT); Procedure: Skin punch biopsy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Skin insulin sensitivity: ratio of phosphorylated to total AKT in skin biopsies

    Investigators will perform Western blots on skin biopsies using antibodies to phosphorylated (T308, S473) and total AKT. The ratio of phosphorylated to total AKT will be determined using densitometry of Western blots and/or by enzyme-linked immunosorbent assays (ELISA), each measured in arbitrary units (AU).

    Measured: Up to 120 minutes from the start of OGTT

Secondary outcomes (5)
  1. Serum triglyceride (TG) level during OGTT

    Measurement of serum triglyceride level (units: mg/dL) during OGTT. A blood test will be done.

    Measured: During OGTT (up to 120 minutes from start of OGTT)

  2. Serum free fatty acid (FFA) levels during OGTT

    Measurement of serum free fatty acid levels (units: mmol/L) during OGTT. A blood test will be done.

    Measured: During OGTT (up to 120 minutes from start of OGTT)

  3. Fasting plasma glucose level

    Plasma glucose (units: mg/dL) after an overnight fast (> 8 hours). A blood test will be done. A healthy (normal) fasting blood glucose level for someone without diabetes is 70 to 99 mg/dL.

    Measured: Before OGTT (baseline = 0 minutes), During OGTT (up to 120 minutes from start of OGTT)

  4. Fasting serum insulin level

    Serum insulin (units: μIU/mL) after an overnight fast (> 8 hours). A blood test will be done. The normal range of fasting insulin varies somewhat between labs, but around 2 to 20 mIU/mL is considered normal by most.

    Measured: Before OGTT (baseline = 0 minutes), During OGTT (up to 120 minutes from start of OGTT)

  5. Fasting serum C-peptide level

    Serum C-peptide (units: ng/mL) after an overnight fast (> 8 hours). A blood test will be done. A normal result of a C-peptide test ranges from 0.5 ng/mL to 2.0 ng/mL (or 0.17 to 0.83 nmol/L).

    Measured: Before OGTT (baseline = 0 minutes), During OGTT (up to 120 minutes from start of OGTT)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Feb 2024
  2. Study start2 Feb 2024
  3. Primary completion12 Nov 2025
  4. Study completion12 Nov 2025

Why it stopped: The study's collaborating dermatologist left the institution, and so skin biopsies could no longer be performed.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case only
Time perspective
Prospective
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06242847
Sponsor's protocol ID
AAAU4674
Status last verified
Feb 2026
First submitted
29 Jan 2024
Last updated
17 Feb 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

An observational study of Psoriasis and Plaque Psoriasis, run by Columbia University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 22 inclusion and 28 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 17 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: The study's collaborating dermatologist left the institution, and so skin biopsies could no longer be performed.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Skin insulin sensitivity: ratio of phosphorylated to total AKT in skin biopsies (time frame: Up to 120 minutes from the start of OGTT). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Feb 2026.

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