Comparative Study between the Efficacy of Platelet Rich Plasma with Methotrexate and Methotrexate Alone in Treatment of Chronic Plaque Psoriasis

Abstract Background Psoriasis affects up to 3% of the world's population or more than 125 million people. There is an urgent need for new treatment strategy, as up to 50% of patients are not satisfied with current therapies. We evaluated the efficiency of combined platelet rich plasma (PRP) and methotrexate (MTX) injection in management of psoriasis vulgaris and combared it with methotrexate injection only. Objectives The aim of this work is to compare between the clinical efficacy of platelet rich plasma with methotrexate and methotrexate alone in treatment of chronic plaque psoriasis. Patients and Methods Forty patients with chronic plaque psoriasis were divided into two groups. Twenty patients were assigned into combinational treatment group (PRP + MTX) and monotherapy group (MTX alone) consisted of another tweenty patients. All patients in combinational therapy group received autologous intralesional PRP at 0,4 and 8 weeks combined with methotrethate im injection once every week for 12 weeks, while patients in monotherapy group received only methotrexate im injection once every week for 12 weeks. Results There were statistically significant decreased DLQI score after 6 and 12 weeks of treatment in females compared to males only in group B, while no significant differences were found between males and females in group A patients, This could be attributed to the greater concern in females as psoriasis is considered as a cosmotic problem. Conclusion Combination treatment of PRP with MTX is more effective than MTX alone in treatment of psoriasis vulgaris.

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Psoriasis

10.1093/med/9780199568741.003.0249 ◽

2018 ◽

Author(s):

Ben Esdaile

Keyword(s):

Plaque Psoriasis ◽

Skin Disease ◽

Psoriasis Vulgaris ◽

Common Variant ◽

Joint Disease ◽

Inflammatory Skin Disease ◽

Chronic Plaque Psoriasis ◽

Inflammatory Skin ◽

Erythematous Plaques

Psoriasis is a common, chronic inflammatory skin disease that is associated with joint disease in approximately 25% of patients. The most common variant of psoriasis is chronic plaque psoriasis (psoriasis vulgaris), which has the hallmark of well-demarcated erythematous plaques covered by silvery scale. There are a number of other variants of psoriasis, including guttate, inverse, palmoplantar, flexural, pustular, and erythrodermic.

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A comparative study of the efficacy and safety of oral apremilast versus oral methotrexate in patients with moderate to severe chronic plaque psoriasis

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20184462 ◽

2018 ◽

Vol 4 (4) ◽

pp. 563

Author(s):

Vinma H. Shetty ◽

Saumya Goel ◽

Amita Murali Babu ◽

Hafsa Eram

Keyword(s):

Comparative Study ◽

Plaque Psoriasis ◽

Systemic Disease ◽

Severity Index ◽

Pde4 Inhibitor ◽

Efficacy And Safety ◽

Chronic Plaque Psoriasis ◽

Oral Methotrexate ◽

Group A ◽

Group B

Background: Psoriasis is a chronic, inflammatory systemic disease. Methotrexate acts by inhibiting dihydrofolic reductase enzyme. Apremilast is an oral PDE4 inhibitor approved by US Food and Drug Administration for treatment of psoriasis.Methods: This is hospital based comparative study conducted from February 2018 to August 2018. Seventy patients above 18 years of age with chronic plaque psoriasis were divided into 35 patients in each group and were treated with oral Apremilast (30 mg twice daily) and oral methotrexate (15 mg per week in three divided doses with a 12-hour interval between doses and tab folic acid on methotrexate free days) and were evaluated every 4 weeks for a period of 16 weeks and followed-up at 24th week. Outcome was assessed on basis of psoriasis area-and-severity index score (PASI), psoriasis disability index (PDI) and clinical photographs.Results: % of improvement in Group-A patients (76.8%) after 16 weeks of treatment was relatively more (p<0.05) as compared to group B (71.5%). At the end of 16 weeks PASI score in methotrexate group was statistically significant (p<0.05) as compared to group B, PDI became 17.90±3.87 in group A and was statistically significant (p<0.05) as compared to group B which was 20.34±2.98. Side effects observed were comparatively less in group A patients.Conclusions: On comparing the two drugs, methotrexate was comparatively better tolerated and had better efficacy and safety. More studies are required to further prove the efficacy of Apremilast in treatment of psoriasis.

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Topical Calcipotriol plus Oral Fumaric Acid Is More Effective and Faster Acting than Oral Fumaric Acid Monotherapy in the Treatment of Severe Chronic Plaque Psoriasis vulgaris

Dermatology ◽

10.1159/000063148 ◽

2002 ◽

Vol 205 (1) ◽

pp. 46-53 ◽

Cited By ~ 45

Author(s):

H. Gollnick ◽

P. Altmeyer ◽

R. Kaufmann ◽

J. Ring ◽

E. Christophers ◽

...

Keyword(s):

Fumaric Acid ◽

Plaque Psoriasis ◽

Psoriasis Vulgaris ◽

Chronic Plaque Psoriasis

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

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20190480 ◽

2019 ◽

Vol 5 (2) ◽

pp. 259

Author(s):

K. Sindhuri ◽

T. Virupakshappa ◽

Anant A. Takalkar

Keyword(s):

Side Effects ◽

Plaque Psoriasis ◽

Ultraviolet B ◽

Chronic Plaque Psoriasis ◽

Oral Methotrexate ◽

Medical College ◽

Pasi Score ◽

Group A ◽

The Difference ◽

Group B

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.

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Association of streptococcal throat infection with plaque psoriasis

Bangladesh Medical Journal ◽

10.3329/bmj.v44i2.27252 ◽

2016 ◽

Vol 44 (2) ◽

pp. 102-104

Author(s):

Mohammed Saiful Islam Bhuiyan ◽

Abida Sultana ◽

Farzana Rabin ◽

AKM Rejaul Haque ◽

ASM Zakaria

Keyword(s):

Plaque Psoriasis ◽

Psoriasis Vulgaris ◽

Throat Swab ◽

Healthy Controls ◽

Chronic Plaque Psoriasis ◽

Cross Sectional ◽

Plaque Type ◽

Throat Infection ◽

Guttate Psoriasis ◽

Medical University

The association of streptococcal sore throat with guttate psoriasis is well established, but its association with psoriasis vulgaris is not yet clear. This cross-sectional observational study was conducted in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from June, 2012 to February 2013 with the intention to ascertain whether streptococcal throat infections are more common in patients with chronic plaque psoriasis. Antistreptolysin O (ASO) titre and culture for ?-haemolytic streptococci was done among thirty four patients with chronic plaque type psoriasis and same number of normal healthy controls. Raised ASO titre was found in 26.5% of patients with psoriasis vulgaris and 11.8% of normal healthy controls (p>0.05). Culture of throat swab for streptococcus ?-haemolyticus was positive in 20.6% of psoriatics and none of controls. Laboratory evidences of streptococcal throat infection are more common in patients with chronic plaque type psoriasis. More clinical trials to see the e_cacy of anti-streptococcal therapy and tonsillectomy in plaque psoriasis should be carried out.Bangladesh Med J. 2015 May; 44 (2): 102-104

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Severe Chronic Plaque Psoriasis Increases Arterial Stiffness Risk

Skin & Allergy News ◽

10.1016/s0037-6337(08)70558-8 ◽

2008 ◽

Vol 39 (8) ◽

pp. 30

Author(s):

BRUCE JANCIN

Keyword(s):

Arterial Stiffness ◽

Plaque Psoriasis ◽

Chronic Plaque Psoriasis

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Randomized trial of medical compression stockings versus two-layer short-stretch bandaging in the management of venous leg ulcers

Phlebologie ◽

10.1055/s-0037-1622268 ◽

2009 ◽

Vol 38 (04) ◽

pp. 157-163 ◽

Cited By ~ 9

Author(s):

A. Franek ◽

L. Brzezinska-Wcislo ◽

E. Blaszczak ◽

A. Polak ◽

J. Taradaj

Keyword(s):

Drug Therapy ◽

Randomized Clinical Trials ◽

Therapy Group ◽

Long Term Results ◽

Leg Ulcers ◽

Compression Stockings ◽

Venous Leg Ulcers ◽

Group A ◽

Group B ◽

Medical Compression Stockings

SummaryA prospective randomized clinical trial was undertaken to compare a medical compression stockings with two-layer short-stretch bandaging in the management of venous leg ulcers. Study endpoints were number of completely healed wounds and the clinical parameters predicting the outcome. Patients, methods: Eighty patients with venous leg ulcers were included in this study, and ultimately allocated into two comparative groups. Group A consisted of 40 patients (25 women, 15 men). They were treated with the compression stockings (25–32 mmHg) and drug therapy. Group B consisted of 40 patients (22 women, 18 men). They were treated with the short-stretch bandages (30–40 mmHg) and drug therapy, administered identically as in group A. Results: Within two months the 15/40 (37.50%) patients in group A and 5/40 (12.50%) in group B were healed completely (p = 0.01). For patients with isolated superficial reflux, the healing rates at two months were 45.45% (10/22 healed) in group A and 18.18% (4/22 healed) in group B (p = 0.01). For patients with superficial plus deep reflux, the healing rates were 27.77% (5/18 healed) in group A and 5.55% (1/18 healed) in group B (p = 0.002). Comparison of relative change of the total surface area (61.55% in group A vs. 23.66% in group B), length (41.67% in group A vs. 27.99% in group B), width (46.16% in group A vs. 29.33% in group B), and volume (82.03% in group A vs. 40.01% in group B) demonstrated difference (p = 0.002 in all comparisons) in favour of group A. Conclusion: The medical compression stockings are extremely useful therapy in enhancement of venous leg ulcer healing (both for patients with superficial and for patients who had superficial plus deep reflux). Bandages are less effective (especially for patients with superficial plus deep reflux, where the efficiency compared to the stockings of applied compression appeared dramatically low). These findings require confirmation in other randomized clinical trials with long term results.

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