In the Comparative Study of Humira vs Methotrexate vs Placebo in Psoriasis Patients (CHAMPION),7 36 of patients achieved PASI 75 after 16 weeks on metho trexate, compared to 80 of patients on adalimumab and 19 of patients in the placebo group. When psoriasis requires systemic therapy, cyclosporine (CsA) is one of the most effective and rapidly acting drugs. Rotational and combination treatments are practical strategies commonly used in clinical setting to reduce the cumulative toxicity of antipsoriasis treatments and to optimize their risk/benefit ratio. Methotrexate versus ciclosporin in psoriasis: effectiveness, quality of life and safety. The mechanism of action of methotrexate in psoriasis is not fully understood; Methotrexate versus cyclosporine in moderate-to-severe chronic plaque psoriasis.
Methotrexate vs cyclosporin in psoriasis: effectiveness, quality of life and safety. a randomized controlled trial. In patients who develop bone-marrow toxicity or gastrointestinal side effects while on folate, increasing the dose of folate may be helpful. Methotrexate vs. ciclosporin in psoriasis: effectiveness, quality of life and safety. Effect of folic or folinic acid supplementation on the toxicity and efficacy of methotrexate in rheumatoid arthritis: a forty-eight week, multicenter, randomized, double-blind, placebo-controlled study. Methotrexate and cyclosporine are well-known systemic therapies for moderate-to-severe chronic plaque psoriasis. A total of 88 patients with moderate-to-severe psoriasis were randomly assigned to treatment for 16 weeks with either methotrexate (44 patients; initial dose, 15 mg per week) or cyclosporine (44 patients; initial dose, 3 mg per kilogram of body weight per day) and were followed for another 36 weeks.
We present a case of methotrexate toxicity manifesting with cutaneous ulceration and review the literature, highlighting practice points relevant to dermatology. Combination therapy of infliximab with methotrexate led to dose reduction of infliximab when compared with combinations of infliximab and azathioprine 15, increased dosing intervals 12, and appears to be well tolerated when compared with methotrexate monotherapy 16. Malignancy concerns with psoriasis treatments using phototherapy, methotrexate, cyclosporin, and biologics: facts and controversies. Psoriatic arthritis is a type of arthritis that causes joint pain, swelling, and stiffness in people with psoriasis. The most serious potential side effects of methotrexate include liver toxicity, lung disease, and bone marrow suppression. Use of apremilast has also been associated with an increase in reports of depression compared with placebo, but it does not cause significant laboratory abnormalities. Side effects of cyclosporine can include impaired kidney function and high blood pressure. The renal toxicity of these agents is reviewed in detail separately. Combination therapy with cyclosporine and methotrexate in severe rheumatoid arthritis. Low-dose short-term cyclosporine versus etretinate in psoriasis: improvement of skin, nail, and joint involvement.
Psoriasis: Recommendations For Methotrexate
For GRADE evaluation of interventions for Psoriasis (chronic plaque), see table. Cyclosporine therapy for children with psoriasis has not been well studied.