Efficacy of Polyherbal Compound Pathadi Tablet and Pathadi Oil in Psoriasis: An Open-label Single Arm Clinical Trial

Introduction: Psoriasis is a chronic inflammatory skin disease that affects the quality of life and is associated with systemic comorbidities. Although conventional therapies are effective, they are limited by safety concerns, relapse after discontinuation, high costs, and limited accessibility in low-resource settings. Ayurveda offers a holistic approach to skin disorders; however, existing evidence primarily highlights purification therapies, which are not always feasible. To address this, the polyherbal compound Pathadi Yogah, referenced in Ashtanga Hridaya for the treatment of skin disorders, was standardised into tablets and oil formulations to make psoriasis treatment more accessible. Aim: To evaluate the clinical efficacy of Pathadi tablet (oral) and Pathadi oil (topical) in patients with plaque psoriasis. Materials and Methods: This single-arm, open-label interventional clinical trial was conducted at the Department of Kayachikitsa, Dr. D. Y. Patil College of Ayurveda and Research Centre, Pimpri, Pune, Maharashtra, India between January 2022 and December 2024. Total of 50 patients (18-60 years of age) with mild-to-moderate plaque psoriasis were included. Patients received the Pathadi tablet (500 mg, twice daily before meals with lukewarm water) and Pathadi oil (topical, twice daily) for 30 days. Assessments were performed at baseline and on days 7, 14, 21, and 30 using the Psoriasis Area and Severity Index (PASI), Simplified PASI, Physician Global Assessment × Body Surface Area (PGA×BSA), and Dermatology Life Quality Index (DLQI). Laboratory parameters were measured at baseline and after treatment. Data were analysed using the Friedman test and the paired t-test. Results: Among the 50 patients included, 25 were males and 25 females with a mean age of 32.4±10.8 years. The scores for erythema, induration, scaling, and itching were significantly reduced (p-value <0.001). The mean PASI declined from 6.04±2.61 to 1.46±1.10 (75.8% reduction, p-value <0.001). The DLQI score improved from 17.74±4.55 to 2.86±2.55 (83.9% reduction, p-value <0.001). A PASI 50 score was achieved in 48 (96%), PASI 75 in 34 patients (68%) and PASI 100 in 9 patients (18%). The Erythrocyte Sedimentation Rate (ESR) values decreased significantly. No adverse events were observed and the patient’s compliance was high. Conclusion: Pathadi tablet and Pathadi oil significantly improved disease severity and quality of life in patients with plaque psoriasis within 30 days. The combined oral and topical approach proved to be a safe, affordable, and easily accessible alternative. Further, larger randomised controlled trials with longer follow-up periods are needed to validate long-term efficacy and relapse prevention.