A Comparison of Efficacy and Adverse Reactions between Methotrexate and Cyclosporine A / 대한피부과학회지

ABSTRACT

BACKGROUND: Psoriasis is a chronic inflammatory dermatosis and various topical or systemic drugs should be selected depending on severity. OBJECTIVE: The purpose of this study was to compare the efficacy and adverse reactions of methotrexate (MTX) and cyclosporine A (CsA) in the treatment of moderate-to-severe plaque psoriasis. METHODS: A retrospective analysis of the therapeutic efficacy of MTX and CsA was performed on 81 patients (MTX 30, CsA; 51) with moderate-to-severe plaque psoriasis. The MTX treatment was administered in weekly doses of 2.5 mg-7.5 mg up to 3 times every 12 hours. The CsA treatment was administered at daily doses of 1.5-5 mg/kg. Regular follow-up and laboratory tests were performed to evaluate the efficacy and adverse reactions of MTX and CsA. RESULTS: Reach to PASI 50 was observed in 93% of patients in the MTX-treated group with an average-time of 4.8 weeks, and in 70% of patients in the CsA-treated group with an average-time of 7.1 weeks. Among nine patients who were switched from MTX to CsA, 55.6% had improved with CsA treatment in 6.6 weeks. In contrast, among the 22 patients who were switched from CsA to MTX, 77.3% had improved with MTX treatment in 5.4 weeks. Adverse reactions to MTX and CsA were observed in 40% and 25% of the treated patients, respectively, most of which were mild and transient. Average relapse-time in patients improved by the drugs was 20.4 weeks in the MTX group and 15.4 weeks in the CsA group. CONCLUSION: Treatment with MTX is found to be a more effective systemic agent than CsA in both therapeutic response and length of relapse-free periods.