Comparative study of oral methotrexate and narrow band ultraviolet-B in chronic plaque psoriasis: a study from urban Karnataka

Authors

  • K. Sindhuri Department of Dermatology, Navodaya Medical College and Hospital, Raichur, Karnataka, India
  • T. Virupakshappa Department of Community Medicine, MIMSR Medical College, Latur, Maharashtra, India
  • Anant A. Takalkar Department of Community Medicine, MIMSR Medical College, Latur, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20190480

Keywords:

Oral methotrexate, Narrow band ultraviolet-B, Chronic plaque psoriasis

Abstract

Background: Treatment of psoriasis continues to be a challenge. It is often frustrating experience for dermatologists. Methotrexate or PUVA or NBUVB when used properly, can produce good to excellent clinical benefit with minimal side effects. The objective of the study was to compare the efficacy and safety of oral methotrexate and NBUVB in the treatment of chronic plaque psoriasis.

Methods: 100 patients of chronic plaque psoriasis attending the skin department of Navodaya Medical College and Hospital, Raichur from November 2012 to April 2014 were included in the study. Group A exhibited to Oral methotrexate and group B to NBUVB. Outcome was measured in terms of PASI 75 (it means 75% reduction in original PASI). Data was analysed using SPSS 19.0 version.

Results: In Group A mean age was 33.68 years and in Group B mean age 33.7 years. The difference in mean PASI at baseline, at 4 and 8 weeks using oral methotrexate as well as NBUVB was found to be highly significant (<0.001). PASI score was less in-group using methotrexate at 4 and 8 weeks interval (<0.05). Mean time taken for PASI 75 in the baseline PASI score in Group A was 9.62±1.3 weeks whereas in Group B it was 11.3±0.7 weeks. Side effects were higher in group B (60%) compared to group A (36%).

Conclusions: Improvement in the PASI score was best with methotrexate than NBUVB. The side effects observed in a methotrexate were minimal compared to NBUVB.

References

Christophers C, Mrowietz U. Psoriasis. In: Fitzpatrick‘s dermatology in internal medicine. Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, edts. 6th ed. New York: The Mc-Graw-Hill companies Inc.; 2003: 407-425.

Christopher E. Psoriasis –Epidemiology and clinical spectrum. Clin Exp Dermatol. 2001;26:314-20.

Kerkhof PCMV. Psoriasis. In: Dermatology. Bolognia JL, Jorizzo JL, Rapini RP, Edts. 1st edn. Mosby; 2003: 125-149.

Callen JP, Shorten CKL, Wolverton SE. Methotrexate. In: Comprehensive Dermatologic drug therapy. Wolverton SE, eds, 1st edn. W.B. Saunders Company; 2004: 147-164.

Cameron H, Dawe RS, Yale S. A randomized observe blinded trial of twice versus three times weekly narrow-band ultraviolet B phototherapy for chronic plaque psoriasis. Br J Dermatol. 2002;147:973-8.

Sharma T, Sepha GC. Psoriasis – clinical study. Indian J Dermatol Venereol. 1964;30:191-7.

Lal S. Clinical pattern of psoriasis in Punjab. Indian J Dermatol Venereol. 1966;35:5-12.

Verma KC, Bhargava NC. Psoriasis – A clinical and some biochemical investigative study. Indian J Dermatol Venereol Leprol. 1979;5:32-8.

Dogra S, Mahajan R. Systemic methotrexate therapy for psoriasis: past, present and future. Clin Exp Dermatol. 2013;38(6):573-88.

Dhir R, Tutakne MA, Chori KVR. Relapse in psoriasis after methotrexate. Indian J Dermatol Venereol Leprol. 1992;58:77-9.

Dayal S, Mayanka, Jain VK. Comparative evaluation of NBUVB phototherapy and PUVA photochemotherapy in choronic plaque psoriasis. Indian J Dermatol Venereol Leprol. 2010;76:533-7.

Radmanesh M, Raflei B, Mossavi ZB, Sina N. Weekly vs daily administration of oral methotrexate for generaralized plaque psoriasis:a randomized controlled clinical trial. Int J Dermatol. 2011;50:1219-3.

Paul BS, Momtaz K, Stem RS, Arndt KA, Parrish JA. Combined methotrexate – Ultraviolet B therapy in the treatment of psoriasis. J Am Acad Dermatol. 1981;7:758-62.

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Published

2019-04-26

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Original Research Articles