Safety and efficacy profile of oral cyclosporine versus oral methotrexate versus oral acitretin in palmoplantar psoriasis ‐ A hospital based prospective investigator blind randomized controlled comparative study

pay.thelady61 shared this article with you from Inoreader Safety and efficacy profile of oral cyclosporine versus oral methotrexate versus oral acitretin in palmoplantar psoriasis ‐ A hospital based prospective investigator blind randomized controlled comparative study Via Dermatologic Therapy ABSTRACT Background Palmoplantar psoriasis (PPP) is a variant of psoriasis which affects only 5% body surface area, but has a devastating impact on affected individual's quality of life. There are few studies assessing efficacy of individual drugs, and few comparative studies of efficacy of two drugs in the literature, however randomized control trial comparing all three drugs against each other has not been done. Methods 75 patients of PPP were enrolled for study and randomly divided into three groups A, B, C of 25 each and assigned for treatment with Cyclosporine (CSA)(2.5‐5mg/kg/day), Methotrexate (MTX)(7.5‐15mg/week) and Acitretin (ACT)(25‐50mg/day) respectively. Modified PASI, PSS, VAS, PGA & PPQOL were used for monitoring response to therapy and improvement in quality of life up to end of study, and thereafter monthly follow‐up was done to find duration of remission for next 90 days. Side effects if any were recorded. Results There was a statistically significant difference in modified PASI for CSA, MTX and ACT. The mean Modified PASI at baseline was 12.8±4.8 for CSA, 12.57±3.8 for MTX and 11.92±3.28 for ACT(P=0.75). Mean Modified PASI reduced to 2.91±1.8 for CSA, 6.57±2.2 for MTX and 4.7±2.2 for ACT at week 5(P=<0.01). Mean Modified PASI further reduced to 0.095±0.35 for CSA, 2.12±1.4 for MTX and 0.78±0.97 for ACT at end of study(P=<0.01). However, Average duration of remission was 9 weeks for ACT group, followed by 6.47 and 3 weeks for CSA and MTX group respectively. Adverse events were comparatively more in ACT group as compared to MTX and CSA groups. Conclusion PPP affects quality of life tremendously and warrants systemic treatment for the same. CSA provides fastest resolution of lesions and have highest efficacy. MTX and ACT have similar efficacy, but ACT provides longer duration of remission. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.