A Comparative Study of the Efficacy of Methotrexate versus Methotrexate with Apremilast in Moderate to Severe Chronic Plaque Psoriasis
Background: Psoriasis is an inflammatory systemic disease with a chronic relapsing course. Methotrexate, a dihydrofolate reductase inhibitor, and Apremilast, an oral phosphodiesterase type 4 inhibitor, are currently the mainstay drugs in the treatment of psoriasis. Aims and Objectives: To compare th...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Dermatology |
| Subjects: | |
| Online Access: | http://www.e-ijd.org/article.asp?issn=0019-5154;year=2023;volume=68;issue=4;spage=393;epage=398;aulast=Srivastava |
| _version_ | 1797649372303851520 |
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| author | Divyanshu Srivastava Arvind Krishna Abhinav David |
| author_facet | Divyanshu Srivastava Arvind Krishna Abhinav David |
| author_sort | Divyanshu Srivastava |
| collection | DOAJ |
| description | Background: Psoriasis is an inflammatory systemic disease with a chronic relapsing course. Methotrexate, a dihydrofolate reductase inhibitor, and Apremilast, an oral phosphodiesterase type 4 inhibitor, are currently the mainstay drugs in the treatment of psoriasis. Aims and Objectives: To compare the efficacy of Methotrexate with a combination of Methotrexate and Apremilast in treating chronic plaque psoriasis. Materials and Methods: The present study was a prospective comparative study conducted among 40 patients, aged above 18 years, with clinically diagnosed psoriasis attending Dermatology OPD of a tertiary care hospital in North India. The study utilised a pre-structured proforma to record a detailed demographic profile and clinical examination related to chronic plaque psoriasis. The patients were divided into two groups of 20 each. Group A was treated with oral Methotrexate, while Group B was treated with oral Apremilast and Methotrexate, and they were evaluated every 4 weeks for 12 weeks. Necessary investigations were done wherever indicated. Results: The male-to-female ratio was 1.35, and the majority (55.0%) of patients belonged to the age group of 31-50 years. 27.5% of patients had comorbidities like diabetes, hypertension, etc., The mean PASI score of group A at the first, second and third follow-ups was higher than that of group B. The reduction in mean PASI score was statistically significant in group B at successive follow-ups, with a percentage improvement of 89.4% at the end of 12 weeks. Conclusions: When comparing monotherapy with methotrexate and multidrug therapy with Methotrexate and Apremilast, multidrug therapy had better efficacy. |
| first_indexed | 2024-03-11T15:45:15Z |
| format | Article |
| id | doaj.art-8524c89a49a14886900534f2df6ef377 |
| institution | Directory Open Access Journal |
| issn | 0019-5154 1998-3611 |
| language | English |
| last_indexed | 2024-03-11T15:45:15Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Dermatology |
| spelling | doaj.art-8524c89a49a14886900534f2df6ef3772023-10-26T06:34:36ZengWolters Kluwer Medknow PublicationsIndian Journal of Dermatology0019-51541998-36112023-01-0168439339810.4103/ijd.ijd_813_22A Comparative Study of the Efficacy of Methotrexate versus Methotrexate with Apremilast in Moderate to Severe Chronic Plaque PsoriasisDivyanshu SrivastavaArvind KrishnaAbhinav DavidBackground: Psoriasis is an inflammatory systemic disease with a chronic relapsing course. Methotrexate, a dihydrofolate reductase inhibitor, and Apremilast, an oral phosphodiesterase type 4 inhibitor, are currently the mainstay drugs in the treatment of psoriasis. Aims and Objectives: To compare the efficacy of Methotrexate with a combination of Methotrexate and Apremilast in treating chronic plaque psoriasis. Materials and Methods: The present study was a prospective comparative study conducted among 40 patients, aged above 18 years, with clinically diagnosed psoriasis attending Dermatology OPD of a tertiary care hospital in North India. The study utilised a pre-structured proforma to record a detailed demographic profile and clinical examination related to chronic plaque psoriasis. The patients were divided into two groups of 20 each. Group A was treated with oral Methotrexate, while Group B was treated with oral Apremilast and Methotrexate, and they were evaluated every 4 weeks for 12 weeks. Necessary investigations were done wherever indicated. Results: The male-to-female ratio was 1.35, and the majority (55.0%) of patients belonged to the age group of 31-50 years. 27.5% of patients had comorbidities like diabetes, hypertension, etc., The mean PASI score of group A at the first, second and third follow-ups was higher than that of group B. The reduction in mean PASI score was statistically significant in group B at successive follow-ups, with a percentage improvement of 89.4% at the end of 12 weeks. Conclusions: When comparing monotherapy with methotrexate and multidrug therapy with Methotrexate and Apremilast, multidrug therapy had better efficacy.http://www.e-ijd.org/article.asp?issn=0019-5154;year=2023;volume=68;issue=4;spage=393;epage=398;aulast=Srivastavaapremilastefficacymethotrexatepsoriasis |
| spellingShingle | Divyanshu Srivastava Arvind Krishna Abhinav David A Comparative Study of the Efficacy of Methotrexate versus Methotrexate with Apremilast in Moderate to Severe Chronic Plaque Psoriasis Indian Journal of Dermatology apremilast efficacy methotrexate psoriasis |
| title | A Comparative Study of the Efficacy of Methotrexate versus Methotrexate with Apremilast in Moderate to Severe Chronic Plaque Psoriasis |
| title_full | A Comparative Study of the Efficacy of Methotrexate versus Methotrexate with Apremilast in Moderate to Severe Chronic Plaque Psoriasis |
| title_fullStr | A Comparative Study of the Efficacy of Methotrexate versus Methotrexate with Apremilast in Moderate to Severe Chronic Plaque Psoriasis |
| title_full_unstemmed | A Comparative Study of the Efficacy of Methotrexate versus Methotrexate with Apremilast in Moderate to Severe Chronic Plaque Psoriasis |
| title_short | A Comparative Study of the Efficacy of Methotrexate versus Methotrexate with Apremilast in Moderate to Severe Chronic Plaque Psoriasis |
| title_sort | comparative study of the efficacy of methotrexate versus methotrexate with apremilast in moderate to severe chronic plaque psoriasis |
| topic | apremilast efficacy methotrexate psoriasis |
| url | http://www.e-ijd.org/article.asp?issn=0019-5154;year=2023;volume=68;issue=4;spage=393;epage=398;aulast=Srivastava |
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