A Comparative Study on Efficacy and Safety of Methotrexate Versus Apremilast in the Management of Chronic Plaque Psoriasis: Tertiary Care Center Based Interventional Study

Introduction: Psoriasis is a common skin presentation in dermatology OPD. Methotrexate and apremilast are frequently used for the management of chronic plaque psoriasis.   Objectives: To compare the efficacy and safety of methotrexate versus apremilast for the management of chronic plaque psori...

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Main Authors: Alisha Aryal, Niraj Bhattarai, Ramesh Sharma Poudel, Smita Jha, Nupendra Shris
Format: Article
Language:English
Published: Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON) 2024-10-01
Series:Nepal Journal of Dermatology, Venereology & Leprology
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Online Access:https://www.nepjol.info/index.php/NJDVL/article/view/67949
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author Alisha Aryal
Niraj Bhattarai
Ramesh Sharma Poudel
Smita Jha
Nupendra Shris
author_facet Alisha Aryal
Niraj Bhattarai
Ramesh Sharma Poudel
Smita Jha
Nupendra Shris
author_sort Alisha Aryal
collection DOAJ
description Introduction: Psoriasis is a common skin presentation in dermatology OPD. Methotrexate and apremilast are frequently used for the management of chronic plaque psoriasis.   Objectives: To compare the efficacy and safety of methotrexate versus apremilast for the management of chronic plaque psoriasis   Materials and Methods: This was an interventional study conducted among 41 patients. The patients were divided into 2 groups. Group A received apremilast 10-30mg twice daily, and group B received methotrexate 10-15mg once weekly for 16 weeks. The patients were evaluated at 4, 8 and 16 weeks. PASI score, DLQI score and adverse effects were documented in every follow-up.   Results: The PASI score significantly reduced from 17.22 ± 8.61 (baseline) to 3.90 ± 2.92 (16 weeks) in group A and 18.64 ± 9.02 (baseline) to 5.95 ± 2.89 (16 weeks) in groups B (P = < 0.001). At 16 weeks, the mean PASI score (3.90 ± 2.92) in group A was significantly less than group B (5.95 ± 2.89) (P = 0.02). The percentage reduction of mean PASI from baseline to 16 weeks was 77% in group A and 68.07% in group B. PASI 75 was achieved by 11 patients (52.30 %) in group A and 8 patients (40 %) in group B at 16 weeks.  Both groups had a significant decrease in DLQI as compared to baseline at 16 weeks, with insignificant differences between the two groups during each visit. No severe side effects were seen in both groups.   Conclusion: Both treatments can be considered in treating chronic plaque psoriasis. However, apremilast showed more efficacy than methotrexate.  
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institution Kabale University
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language English
publishDate 2024-10-01
publisher Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)
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spelling doaj-art-ade08ef167344c7b834f1ba60bc79f7e2025-08-23T10:03:32ZengSociety of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)Nepal Journal of Dermatology, Venereology & Leprology2091-02312091-167X2024-10-0122210.3126/njdvl.v22i2.67949A Comparative Study on Efficacy and Safety of Methotrexate Versus Apremilast in the Management of Chronic Plaque Psoriasis: Tertiary Care Center Based Interventional StudyAlisha Aryal0https://orcid.org/0000-0003-1292-9063Niraj Bhattarai1Ramesh Sharma Poudel2Smita Jha3Nupendra Shris4Nepalgunj Medical College, Kohalpur, Banke, NepalSushil Koirala Prakhar Cancer Hospital, Banke, NepalNepalgunj Medical College, Kohalpur, Banke, NepalNepalgunj Medical College, Kohalpur, Banke, NepalNepalgunj Medical College, Kohalpur, Banke, Nepal Introduction: Psoriasis is a common skin presentation in dermatology OPD. Methotrexate and apremilast are frequently used for the management of chronic plaque psoriasis.   Objectives: To compare the efficacy and safety of methotrexate versus apremilast for the management of chronic plaque psoriasis   Materials and Methods: This was an interventional study conducted among 41 patients. The patients were divided into 2 groups. Group A received apremilast 10-30mg twice daily, and group B received methotrexate 10-15mg once weekly for 16 weeks. The patients were evaluated at 4, 8 and 16 weeks. PASI score, DLQI score and adverse effects were documented in every follow-up.   Results: The PASI score significantly reduced from 17.22 ± 8.61 (baseline) to 3.90 ± 2.92 (16 weeks) in group A and 18.64 ± 9.02 (baseline) to 5.95 ± 2.89 (16 weeks) in groups B (P = < 0.001). At 16 weeks, the mean PASI score (3.90 ± 2.92) in group A was significantly less than group B (5.95 ± 2.89) (P = 0.02). The percentage reduction of mean PASI from baseline to 16 weeks was 77% in group A and 68.07% in group B. PASI 75 was achieved by 11 patients (52.30 %) in group A and 8 patients (40 %) in group B at 16 weeks.  Both groups had a significant decrease in DLQI as compared to baseline at 16 weeks, with insignificant differences between the two groups during each visit. No severe side effects were seen in both groups.   Conclusion: Both treatments can be considered in treating chronic plaque psoriasis. However, apremilast showed more efficacy than methotrexate.   https://www.nepjol.info/index.php/NJDVL/article/view/67949ApremilastChronic plaque psoriasisEfficacyMethotrexate
spellingShingle Alisha Aryal
Niraj Bhattarai
Ramesh Sharma Poudel
Smita Jha
Nupendra Shris
A Comparative Study on Efficacy and Safety of Methotrexate Versus Apremilast in the Management of Chronic Plaque Psoriasis: Tertiary Care Center Based Interventional Study
Nepal Journal of Dermatology, Venereology & Leprology
Apremilast
Chronic plaque psoriasis
Efficacy
Methotrexate
title A Comparative Study on Efficacy and Safety of Methotrexate Versus Apremilast in the Management of Chronic Plaque Psoriasis: Tertiary Care Center Based Interventional Study
title_full A Comparative Study on Efficacy and Safety of Methotrexate Versus Apremilast in the Management of Chronic Plaque Psoriasis: Tertiary Care Center Based Interventional Study
title_fullStr A Comparative Study on Efficacy and Safety of Methotrexate Versus Apremilast in the Management of Chronic Plaque Psoriasis: Tertiary Care Center Based Interventional Study
title_full_unstemmed A Comparative Study on Efficacy and Safety of Methotrexate Versus Apremilast in the Management of Chronic Plaque Psoriasis: Tertiary Care Center Based Interventional Study
title_short A Comparative Study on Efficacy and Safety of Methotrexate Versus Apremilast in the Management of Chronic Plaque Psoriasis: Tertiary Care Center Based Interventional Study
title_sort comparative study on efficacy and safety of methotrexate versus apremilast in the management of chronic plaque psoriasis tertiary care center based interventional study
topic Apremilast
Chronic plaque psoriasis
Efficacy
Methotrexate
url https://www.nepjol.info/index.php/NJDVL/article/view/67949
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