EVALUATION OF METHOTREXATE EFFICIENCY IN COMPARISON TO ALTERNATIVE DRUGS FOR THE TREATMENT OF PSORIASIS IN THE UK ADULT POPULATION: A SYSTEMATIC REVIEW
Background: Psoriasis is a skin condition that affects elbows, knees, back and scalp. It forms thick red patches of dead skin in the affected area where the dermis becomes red and swollen.
Objectives: To compare and evaluate the uses of methotrexate and other drugs; and their efficiency on psoriasis using various clinical studies.
Method: Research for randomised controlled trials has been done. These describe treatment investigations used in clinical practice. A systematic literature search has identified 10 clinical trials.
Results: The first clinical study observed that infliximab was more successful than methotrexate in treatment of moderate to severe psoriasis. Infliximab was administered intravenously and methotrexate orally. The treatment with infliximab started with 653 patients, from which 541 have completed the treatment successfully. The progression of disease during the treatment 0 and only 9 patients switched treatment. The total amount of patients who started the methotrexate treatment was 215 from which 127 have successfully completed it. The progression of disease was 2 and 63 patients switched treatment. In the last study it was also found out that a treatment with infliximab and methotrexate together is more effective than administering them on their own. The adverse event was 0, treatment fail 1 and a total of 17 subjects of 20 were successfully treated. It has been observed that methotrexate was significantly less effective than ustekinumab, etanercept and ABT-874. An alternative treatment with efalizumab has been found to treat subjects who have a contraindication to methotrexate.
Conclusion: This systematic review shows that treatment with methotrexate only is less effective than combined with other drugs. A good alternative is to combine it with infliximab or to administrate other medicines found to be more successful in treating adult patients with severe psoriasis.