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

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> % of improvement in Group-A patients (76.8%) after 16 weeks of treatment was relatively more (p&lt;0.05) as compared to group B (71.5%). At the end of 16 weeks PASI score in methotrexate group was statistically significant (p&lt;0.05) as compared to group B, PDI became 17.90±3.87 in group A and was statistically significant (p&lt;0.05) as compared to group B which was 20.34±2.98. Side effects observed were comparatively less in group A patients.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

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

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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 (&lt;0.001). PASI score was less in-group using methotrexate at 4 and 8 weeks interval (&lt;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%).</p><p class="abstract"><strong>Conclusions:</strong> Improvement in the PASI score was best with methotrexate than NBUVB. The side effects observed in a methotrexate were minimal compared to NBUVB.</p>

scholarly journals A comparative study of efficacy and safety of glucosamine plus chondroitin sulphate versus rosehip as add on therapy to NSAIDs in patients suffering from osteoarthritis

2018 ◽  
Vol 7 (11) ◽  
pp. 2254
Author(s):  
Kiranpreet Kaur ◽  
Anjleen Kaur ◽  
Prabhsimran Singh ◽  
Amandeep Singh Bakshi
Keyword(s):  
Comparative Study ◽  
Chondroitin Sulphate ◽  
Tertiary Care ◽  
Efficacy And Safety ◽  
Tertiary Care Centre ◽  
Open Label ◽  
Significant Difference ◽  
Group A ◽  
Efficacy Parameters ◽  
Group B

Background: Osteoarthritis is a chronic and debilitating disease. Management of disease is a big challenge. NSAIDS play an important role but have many adverse reactions. So, this study was designed to evaluate the efficacy and safety of natural compound rosehip versus glucosamine and chondroitin sulphate in patients of osteoarthritis.Methods: An open label, randomized, parallel group comparative study, conducted on patients of either sex with confirmed diagnosis of osteoarthritis on standard NSAIDs therapy, attending the outpatient department of orthopedics in a tertiary care centre.  150 patients were enrolled and divided into three groups (group A, group B and group C) of 50 each. Patients of group A were given Glucosamine plus chondroitin sulphate for 12 weeks. Group B was given rosehip for 12 weeks and group C placebo.  These supplements were given as add on therapy.  Patients were monitored and adverse drug reactions were noted. The data was analysed statistically using t- test for efficacy and descriptive stats for assessing the safety.Results: Efficacy was assessed by comparing mean reduction in the pain intensity between group A and B, group B gives highly significant results as compared to group A. While comparing joint tenderness, swelling around joint, mean functional capacity and improvement in the overall assessment, group B gives significant results as compared to group A. It was also observed that group A and group B were better than group C in all the efficacy parameters. All the drugs were well tolerated and systemically safe.Conclusions: There was significant difference in efficacy of rosehip compared with glaucosamine and chondroitin sulphate in patients of osteoarthritis. In comparison there was no significant difference in safety of two drugs and both were considered safe in patients.

scholarly journals A retrospective comparative study to evaluate the efficacy and safety of mifepristone with misoprostol over misoprostol alone in induction in labor

2018 ◽  
Vol 7 (12) ◽  
pp. 5140
Author(s):  
Reena Sharma ◽  
B. R. Sharma ◽  
Poojan Dogra
Keyword(s):  
Comparative Study ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Efficacy And Safety ◽  
Group A ◽  
The Mean ◽  
Group 2 ◽  
Group B ◽  
Retrospective Comparative Study ◽  
Group 1

Background: The aim is to compare the improvement in pre-induction Bishop’s score, proportion of patients going in labor and induction–delivery interval after using the Misoprostol versus Mifepristone and Misoprostol as cervical ripening and labor inducing agent.Methods: It is retrospective comparative study conducted on 110 women. Women were randomized in group A and in group B of 55 patients in each group. Group A received tab Mifepristone 200 mg orally on day 1 followed by Misoprostol 25 ug after 48 hours and continued 6 hourly till maximum four tablets and group B patients received tablet Misoprostol 25ug and continued 25ug 6hrly maximum 4 doses. Women observed for improvement in Bishop‟s score, induction-delivery interval and requirement of subsequent doses of Misoprostol.Results: Present study concluded that tablet Mifepristone is an efficient cervical ripening and inducing agent of labor as pre-induction Bishop’s score was improved. 36.4%patients went into labor only with tablet Mifepristone. The mean induction-delivery interval was,19±12.2hrs in Group 1 as compare to 13.1±13.0 hrs in Group 2. Mean Bishop’s score observed in Group 1 were 2.5±1.78 and 1.67±1.25 in Group 2. It was observed that there was significant improvement in the Bishop’s score after giving Mifepristone to the patients; mean Bishop’s 24hrs after mifepristone were 4.03±1.80. Repeated dose of Misoprostol required in Group 1 was observed to be higher than group 2 as shown in table 8. Mean misoprostol doses required in group 1 was 2.56±1.15 as compared to 1.71±1.58 in group 2.Conclusions: Mifepristone with Misoprostol reduce the induction delivery interval and more potent in combination for induction of labour as compared to Misoprostol alone.

scholarly journals Efficacy and safety of intralesional triamcinolone acetonide in the treatment of chronic hand eczema

2017 ◽  
Vol 10 (3) ◽  
pp. 129
Author(s):  
Tasnuva Ashraf ◽  
Harashit Kumar Paul ◽  
Md. Shahidullah Sikder ◽  
A. S. M. Zakaria ◽  
Saiful Islam Bhuiyan ◽  
...  
Keyword(s):  
Triamcinolone Acetonide ◽  
Severity Index ◽  
Hand Eczema ◽  
Clobetasol Propionate ◽  
Controlled Clinical Trial ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Chronic Hand Eczema ◽  
Group A ◽  
Group B

<p class="Abstract">This randomized controlled clinical trial was conducted to assess the efficacy and safety of intralesional triamcinolone acetonide in the treatment of chronic hand eczema comparing with topical clobetasol propionate. A total 60 patients of chronic hand eczema were recruited in the study. Thirty patients (Group A) were treated with intralesional triamcinolone acetonide and the rest 30 (Group B) with topical clobetasol propionate. Severity and improvement were assessed using Hand Eczema Severity Index (HECSI) score. The patients of both groups were followed up at 4<sup>th</sup> week and 12<sup>th</sup> week. In Group A, median HECSI score at baseline, 4<sup>th</sup> week and 12<sup>th</sup> week were 3, 20 and 20 respectively; whereas these scores were 54, 10 and 8 in Group B. In both groups, HECSI score was decreased gradually but the rate was higher in Group B than Group A (p&lt;0.05). Thinning of skin, an adverse effect, was seen in patients of both the intralesional triamcinolone acetonide (10%) and topical clobetasol propionate (16.7%) groups (p&gt;0.05). The result of this study demonstrates that intralesional triamcinolone acetonide is effective and safe in treating chronic hand eczema but less effective than the topical clobetasol.</p>

scholarly journals Topical Betamethasone Valerate and Calcipotriol Ointments for the Therapyof Mild and Moderate Psoriasisvulgaris: A Randomized, Comparative Study

2018 ◽  
Vol 23 (4) ◽  
pp. 435-438
Author(s):  
Sana Imran ◽  
Sarwat Jahan ◽  
Mohammad Sair
Keyword(s):  
Comparative Study ◽  
Severity Index ◽  
Treated Group ◽  
Betamethasone Valerate ◽  
Psoriasis Area Severity Index ◽  
Pakistani Population ◽  
Pasi Score ◽  
Group A ◽  
Group B ◽  
Psoriasis Severity

To determine the effectiveness of both topically applied Betamethasone valerate and Calcipotriol ointments for the therapy of mild and moderate types of psoriasis. This comparative study was conducted in Jinnah Postgraduate Medical Centre, Karachi in the Pharmacology and Therapeutics department of BasicMedical Science Institute (BMSI). In 90 days study, 80 patients of mild and moderate psoriasis vulgaris were placed into A and B groups. The Betamethasone valerate treated patients were placed in group A while Calcipotriol treated patients were placed in group B; 40 patients in each group. The Psoriasis AreaSeverity Index (PASI criterion) was used to observe improvement in psoriatic patients taking these drugs. In this randomized and comparative study, psoriasis severity was checked by Psoriasis Area Severity Index (PASI). At day 90 Calcipotriol treated group B patients showed more improvement in mean PASI score ascompared to Betamethasone valerate treated group A patients. In PASI score, Calcipotriol shows 71.61% betterment whereas Betamethasone vale rate shows 63.2% betterment in mild psoriatic patients. In PASI score, Calcipotriol shows 69.21% betterment whereas Betamethasone valerate shows 60.44% betterment inmoderate psoriatic patients. In Pakistani population topically applied Calcipotriol ointment was more efficacious in the treatment of mild and moderate types of psoriasisvulgaris when compared to topically applied Betamethasone valerate ointment.

scholarly journals Successful Psoriasis Treatment Using NB-UVB with Methotrexate: The Vietnamese Experience

2019 ◽  
Vol 7 (2) ◽  
pp. 253-255
Author(s):  
Em Dang Van ◽  
Thuy Pham Diem ◽  
Van Bui Thi ◽  
Tam Huynh Thi Xuan ◽  
Khai Ly Tuan ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Recurrence Rate ◽  
Plaque Psoriasis ◽  
Severity Index ◽  
Ultraviolet B ◽  
Chronic Plaque Psoriasis ◽  
Oral Methotrexate ◽  
Psoriasis Treatment ◽  
Plaque Type ◽  
Better Than

AIM: To compare the effectiveness of narrowband ultraviolet B (NBUVB) and oral methotrexate (MTX) to oral MTX alone in Vietnamese psoriasis patients, from May 2016 to May 2018. METHODS: We conducted a non-randomized trial on 70 patients with plaque-type psoriasis of moderate to severe. Thirty-five patients apply NBUVB once/day in 5 days/week for 4 weeks plus oral MTX 7.5 mg/week and 35 patients oral MTX 7.5 mg/week and both two groups treatment for 3 months. The extent of the lesion was assessed by the Psoriasis Area and Severity Index (PASI). RESULTS: The proportion of decreasing PASI was comparable (68.49% in NBUVB and MTX versus 57.62% in MTX alone); p < 0.05. Inside, good 28.58%, moderate 68.57% and poor 2.85% in NBUVB and MTX better than good 2.85%, moderate 71.4% and poor 25.72% in MTX alone; p < 0.05. The recurrence rate after 24 months of the NBUVB and MTX group (42.9%) was lower than the MTX alone group (71.4%); p < 0.05. CONCLUSION: NBUVB and oral MTX have affected treatment with chronic plaque psoriasis better than oral MTX alone.

scholarly journals A Comparative Study of Ingudi phalamajja Lepa and Ananatmul Ghan in The Management of Vyanga (Melasma)

2020 ◽  
Vol 11 (2) ◽  
pp. 331-336
Author(s):  
Shraddha Wake ◽  
Vaishali Kuchewar ◽  
Prajkta Hagone
Keyword(s):  
Comparative Study ◽  
Clinical Features ◽  
Severity Index ◽  
Melanin Pigment ◽  
Local Application ◽  
Active Principle ◽  
Common Disorder ◽  
Group A ◽  
Group B

The normal color of skin in human is largely due to melanin pigment. Melasma is most common disorder which is related to melanin. It is a human melanogenesis dysfunction that results in localized, chronic acquired hypermelanosis of the skin. In Ayurveda melasma can be correlated with Vyanga because of resemblance of its clinical features. According to Acharya Charak, it is caused due to vitiation of Pitta and Shonita  but other Acharyas has depicted it due to the vitiation of Vāta and Pitta. This study is aimed to explore the Efficacy of Ingudi Phalmajja lepa with and without internal use of Anantamoola Ghana in Vyanga. Total 43 patients were registered and randomly divided into group A and group B by lottery method. Out of these, 40 patients have completed the treatment. All patients were examined by Wood’s Lamp to assess the depth of pigmentation (Dermal/Epidermal).. It is concluded that vyanga is frequent in females than males. It was found in madhyamavastha in which pitta dosha and Rajoguna is predominant. Mostly Centrofacial type of melasma is found in this study which is supported by other studies. Melasma Severity Index is improved in both the groups. Local application of Ingudi phalmajja is found to be effective in the severity of pigmentation. The action of Ingudi phalamajja in hyperpigmentation could not be evaluated. Further study can be conducted to find out the active principle of Ingudi. 

scholarly journals Methotrexate Versus Methotrexate Plus Folic Acid in the Treatment of Moderate to Severe Plaque Psoriasis: A Randomized Clinical-Trial

2016 ◽  
Vol 14 (1) ◽  
pp. 29-36
Author(s):  
D.K. Khadka ◽  
S. Agrawal ◽  
T.K. Dhali
Keyword(s):  
Adverse Effect ◽  
Folic Acid ◽  
Plaque Psoriasis ◽  
Negative Impact ◽  
Severity Index ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Psoriasis is a chronic, recurring inflammatory disease affecting the skin, joints and nails that has a significant negative impact on the quality of life. Efficacy of methotrexate versus combination of methotrexate plus folic acid in the treatment of psoriasis has been rarely assessed.Objectives: To compare the efficacy of methotrexate versus methotrexate plus folic acid in the treatment of moderate to severe chronic plaque psoriasisMaterial and Methods: Eighty patients with moderate to severe chronic plaque psoriasis were randomized to receive either methotrexate (group A) or methotrexate plus folic acid (group B). End point of treatment was 75% reduction in Psoriasis Area and Severity Index (PASI 75) score or upto 3 months, whichever was earlier. Patients were then followed up for a period of 12 weeks for assessment of relapse, DLQI and adverse effects.Results: Of 80 patients, 71 completed the treatment and follow up period (33 in group A, and 38 in group B). PASI 75 was achieved in 34/40(85%) patients in group A and 32/40(80%) patients in group B (P < 0.142). There was statistically significant number of patients who had greater adverse effect in methotrexate than in methotrexate plus folic acid (p=0.020). There was significant difference in the number of patients who relapsed during the follow-up period (P = 0.013) with more relapse in group B.Conclusion: Combination of methotrexate and folic acid developed lesser adverse effect and greater relapse in comparison to methotrexate alone.Nepal Journal of Dermatology, Venereology & Leprology, Vol.14(1) 2016, pp.29-36

COMPARATIVE STUDY IN BETWEEN INTRALESIONAL VITAMIN D3 AND INTRALESIONAL BLEOMYCIN IN THE TREATMENT OF CUTANEOUS VERRUCAE

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Shrikant . ◽  
R.D. Mehta ◽  
B.C. Ghiya
Keyword(s):  
Partial Response ◽  
Comparative Study ◽  
Recurrence Rate ◽  
Vitamin D3 ◽  
Complete Response ◽  
Recurrence Rates ◽  
Additional Advantage ◽  
Cost Effective Treatment ◽  
Group A ◽  
Group B

Background: Verruca is one of the common dermatopathologies which has multiple therapeutic options but with variable success rates, refractory cases and high recurrence rates. Nowadays, treatment with intralesional injections has gained recognition due to its effectiveness in clearing verrucae. These act by stimulating the cell-mediated immunity. Out of scores of options available for intralesional therapeutics, Vitamin D3 appears to be more promising but least evaluated. Therefore, we planned to evaluate the efficacy of intralesional Vitamin D3 in various types of cutaneous verrucae. Simultaneously the results were compared with intralesional bleomycin, also. Methods: A total of 200 patients of cutaneous verrucae with varying size and duration were included in the experimental randomized comparative study. We divided them into two groups. Group A, comprising of 100 patients, received 0.2-0.5 ml intralesional Vitamin D3 (600,000 IU, 15mg/ml) and Group B, also of hundred subjects, received intralesional Bleomycin (1 mg/ml) into the base of verrucae. A maximum of 5 verrucae were injected per session at 3 weeks interval until resolution or for a maximum of 4 sessions. Patients were followed up for 6 months after the last injection to assess the clearance status and detect any recurrence. Results: In Group A (Vitamin D3), 'Complete response', 'Partial response' and 'No response' were observed in 85.07%, 6.74% and 8.17% respectively after 4 sessions. Recurrence rate was 0.81% after 6 months. In Group B (Bleomycin), 'Complete response', 'Partial response' and 'No response' were found in 77.99%, 10.47% and 11.53% in the series. Recurrence rate was 1.71%, comparatively higher in group B. Conclusion: The efficacy of intralesional Vitamin D3 was found significantly higher as compared to intralesional Bleomycin in the treatment of cutaneous verrucae with less recurrence rates. Vitamin D3 has an additional advantage of cost-effective treatment over Bleomycin. We purpose its use, as a primary mode of treatment in various types of cutaneous verrucae. Keywords: Bleomycin, Vitamin D3, Verrucae.

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