Guidelines on the Use of Methotrexate in Psoriasis

Pattern of drug use in the management of psoriasis in a tertiary care hospital: a prospective study

“…4,6 Among the study patients, 70 (57.85%) were males and 51 (42.15%) were females, indicating higher prevalence in males, as also observed in other studies.…”

“…The baseline PASI score recorded was in accordance with other studies, which have also observed that majority of the patients had less severe lesions with PASI <10. [6][7][8][9]11,16,17 Most of the patients (n=95; 78.51%) were treated with topical medications, which included GC, SA, calcitriol and coal tar, either as monotherapy or in combination of two or more drugs, in the form of creams or ointments. Clobetasol and halobetasol are the most potent topical steroids preferred in psoriasis for their anti-inflammatory and antiproliferative action.…”

“…Among the GCs, clobetasol was used in majority of the cases. 5,6,16,17,[19][20][21] Systemic therapy with oral Mtx 7.5 mg once weekly, supplemented with folic acid, was used in eight patients (6.61%) with severe chronic plaque psoriasis with base line PASI score >7, in combination with topical therapy. Topical therapy included GCs as monotherapy in five patients, GC + calcitriol + SA in one patient, GC + calctriol in one patient and GC + SA in one patient.…”

“…Similar pattern of triple therapy has been reported in several other studies, but considered only for those cases with baseline PASI score >10. 6,[16][17][18]21,22 In GC monotherapy used as clobetasol, halobetasol and betamethsone (n=66), the decrease in the mean baseline score was 91.03%, which was highly significant (p<0.001). In patients treated with GC + SA (n=15), the decrease after 12 weeks of therapy was 82.73%.…”

A novel nanogel formulation of methotrexate for topical treatment of psoriasis: optimization, in vitro and in vivo evaluation

“…It is approved by the U.S. FDA in early 1972 for the treatment of psoriasis. Although approved for the treatment of mild and moderate psoriasis with oral and parenteral administration, it causes mucosal ulceration, stomatitis, bone marrow suppression, hepatic fibrosis and cirrhosis on chronic use 4 . Hence, topical administration of MTX would be advantageous to patients to avoid its adverse effects 5 .…”