Methotrexate Well Tolerated, Effective for Psoriasis in Chinese
Greater therapeutic response, fewer adverse events seen in those without psoriatic arthritis
THURSDAY, Jan. 31, 2019 (Pharmacist's Briefing) -- Methotrexate is well tolerated and effective for psoriasis in a Chinese population and is more effective for those without psoriatic arthritis, according to a study published online Jan. 30 in JAMA Dermatology.
Kexiang Yan, M.D., Ph.D., from Fudan University in Shanghai, and colleagues conducted a prospective intervention study involving 235 patients with psoriasis (107 without psoriatic arthritis and 128 with psoriatic arthritis). Participants received a 12-week course of low-dosage oral methotrexate.
The researchers found that at week 8 and week 12, response rates for 90 percent reduction from baseline Psoriasis Area Severity Index scores were significantly lower in patients with versus those without psoriatic arthritis (3.1 versus 11.2 percent and 14.8 versus 25.2 percent, respectively). Compared with patients without psoriatic arthritis, those with psoriatic arthritis had a significantly higher incidence of adverse events, including dizziness (9.4 versus 0.9 percent), gastrointestinal symptoms (25.0 versus 12.1 percent), and hepatoxicity (26.6 versus 15.0 percent). Correlations were seen for methotrexate-induced elevation of alanine aminotransferase levels with body mass index and smoking.
"Although multicenter trials with larger sample size are needed to confirm these results, our findings suggest that methotrexate can be recommended as first-line treatment for psoriasis without arthritis," the authors write.