A comparative study of assessment of clinical response of methotrexate versus apremilast in chronic plaque psoriasis

Abstract

Objectives: Methotrexate (MTX) is one of the oldest conventional agents used for management of chronic plaque psoriasis, and apremilast (APM) is a recent small molecule for the treatment of chronic plaque psoriasis. The objective of this study was to compare the clinical response of patients with chronic plaque psoriasis treated with MTX versus APM. Materials and Methods: This is a 1½ year descriptive observational study of all new chronic plaque psoriasis patients. The sample size was 64 (31 in MTX group and 33 in APM group). Sixty-four patients diagnosed with chronic plaque psoriasis were treated with MTX or APM. The patients were evaluated for therapeutic outcome by psoriasis area and severity index (PASI) score at 4 weeks, 12 weeks, and 24 weeks. The efficacy of drugs was compared using PASI 75. The data obtained from the patient was entered in Microsoft Excel and analyzed using the Statistical Package for the Social Sciences software. Results: Out of the 64 patients, 31 were treated with MTX and 33 patients were treated with APM. At 12 weeks, 35.5% of patients receiving MTX group achieved PASI 75 whereas only 9% of patients achieved PASI 75 in APM group which was found to be statistically significant (P = 0.01). The PASI 75 was achieved by 93.5% of patients in the MTX group and 87.9% of patients in the APM group with no statistical significance at 24 weeks. Conclusion: The MTX and APM demonstrated equal efficacy in the treatment of chronic plaque psoriasis at the end of 24 weeks.