Psoriasis is a disease of immunological origin that damages the skin and mucous membranes. Biological therapies with systemic medications are effective in treating moderate and severe psoriasis. Our objective was to evaluate the effects of methotrexate and etanercept treatment in this disease and to verify their response to the Psoriasis area and severity index (PASI) index in the initial and control phase. The number of patients treated at the Military Hospital in Guayaquil was 2.620 corresponding from July 2020 to July 2021; the selected sample according to the inclusion criteria was 94 patients with moderate and severe psoriasis. The method was retrospective, observational, descriptive, cross-sectional, correlational differential analytical, and approved by the Human Subjects Ethics Committee of the Specialties Hospital "Dr Teodoro Maldonado Carbo" of Guayaquil, Ecuador. In this study, the prevalence was 3.58%, and the body mass index was 28.13 corresponding to overweight and obesity. The PASI index in the initial stage before treatment was 10.8% and in the control phase, it decreased to 2.99%, showing a decrease in lesions and good improvement in the treatment of moderate and severe psoriasis. Student´s T, the combination of etanercept with methotrexate was compared with the response with the PASI index in the initial and control phases, presenting a value lower than 0.001, P = .05, which was very significant. In our study, treatment with etanercept and methotrexate in moderate and severe psoriasis had is a favorable response in reducing this disease. It is expected that, in Ecuador, the health authorities would implement the biologics for the treatment of moderate and several psoriasis and including them in the basic list of medicines of the Public Health Ministry.Abbreviations: BMI = body mass index, PASI = Psoriasis area and severity index, WHO = World Health Organization.
Background. - Plaque psoriasis is a disease of immunological origin that damages the skin, mucous membranes. Biological therapies combined with systemic medications are effective in treating plaque psoriasis. Our objective was to evaluate the treatment of Etanercept with methotrexate and to verify its response with the PASI index in its initial and control phase. Methodology. - The Universe of patient treated at the Military Hospital in Guayaquil was 2.620 corresponding from January until July 2020; the selected sample according to the inclusion criteria was 94 patients with plaque psoriasis. The method was retrospective, observational, descriptive, cross-sectional, correlational differential analytical. Result. - In this study, the prevalence was 3.58%, The BMI index was 28.13 corresponding to overweight and obesity. The PASI index in the initial stage before treatment showed 10.8% and in the control phase, it fell to 2.99%, showing a decrease in lesions and good improvement to the combined treatment. In Student´s T, the combination of Etanercept with Methotrexate was compared with de evolution of PASI index, in the initial and control phases, presenting a value lower than 0.001 < P = 0.05, this response being very significant Discussion. - In our study, the combination of Etanercept with Methotrexate has a favorable this disease response in reducing this disease. It´s expected that, in Ecuador, the Health Authorities would implement the Biologics for the treatment of plaque psoriasis and including them in the basic list of medicines of the Public Health Ministry.
Introduction: Psoriasis is an inflammatory skin disease. The objective of this study was to evaluate the effectiveness and efficacy of a natural topical cream and compare it with the gold-standard topical cream. Methodology: Randomized clinical trial, in 100 healthy volunteer subjects, five formulations of the new product were prepared and applied to 20 healthy subjects for each formulation. Of the 270 patients with psoriasis, 120 volunteer patients were selected; 60 patients were randomly administered the full natural product, and as a control group, 60 patients were treated with corticosteroid cream at the TMC Hospital. Outcome: Application in 100 healthy subjects showed that 99% had no side effects. When applied to patients with psoriasis at the TMC Hospital, the response was evaluated 10 days after treatment by comparing the results with a corticosteroid. Categorical variables are expressed as frequencies and percentages, and differences were analyzed using Pearson's chi-square test. Using Student’s t-test for paired tests, the differences before and after treatment between the medians of the continuous variables were analyzed and found to be significant. The distribution of the variables was analyzed using the nonparametric Mann-Whitney U test with the clinical variables, as well as with the PASI index and SBA, resulting in a highly significant P value of 0.000, which showed that the topical natural cream was effective in reducing the characteristic clinical signs in the skin of patients with psoriasis. Discussion: The application of the new natural cream with anti-inflammatory, exfoliating, soothing, disinfectant, antimicrobial, and healing properties showed that 99% of healthy subjects and patients had no side effects, presenting a rapid, statistically significant efficacy, whose results were compared with a topical corticosteroid 10 days after treatment. The new natural topical cream showed a remitting effect in the third month after the control. This cream was approved for commercialization in February 2023 by the Regulatory and Health Control Agency of Ecuador (ARCSA). As it is effective and efficient in patients with plaque psoriasis and its components are of natural origin, its application is recommended in this type of immunological disease whose improvement was clinically manifested from the beginning of the treatment.
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