Psoriasis Patients Without Psoriatic Arthritis Benefit More From Methotrexate

A study of methotrexate in patients with psoriasis found that the immunosuppressive drug was more effective in patients without psoriatic arthritis than those with the added condition. Additionally, patients without psoriatic arthritis had fewer adverse effects than those with psoriatic arthritis.

“Our study demonstrated that methotrexate was well tolerated by Chinese outpatients with psoriasis,” wrote study authors Kexiang Yan, MD, PhD, Yuanjing Zhang, MD, Ling Han, MD, PhD, et al. “Methotrexate appeared to be more effective and had fewer adverse effects in patients without psoriatic arthritis compared with those with psoriatic arthritis.”

This prospective, single-arm study was performed at the Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China, and enrolled 248 patients with moderate to severe psoriasis with or without psoriatic arthritis. Of those, 235 patients completed the 12-week study—none withdrew due to adverse effects.

The severity and extent of psoriasis in study participants was graded by 2 dermatologists using the Psoriasis Area Severity Index (PASI) and body surface area (BSA) scores. The mean (SD) baseline PASI score was 13.9 (7.4) and the mean (SD) baseline BSA score was 29.7 (20.8).

t week 8, the 90% reduction from baseline PASI score (PASI90) response rates were significantly higher in patients without than those with psoriatic arthritis (12 [1.9%] vs 4 [3.1%]; P = .02). This continued at week 12 (27 [25.2%] vs 19 [14.8%]; P = .049).

The PASI50 and PASI75 response rates at both week 8 and week 12 were not statistically different between the 2 groups of participants.

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