Oral vs SC en psoriasis finalmente hay prueba.
Comparison of the clinical efficacy of subcutaneous versus oral administration of methotrexate in patients with psoriasis vulgaris: a randomized controlled trial
Clin Exp Dermatol. 2022 Jan 11 [Epub ahead of print]
BACKGROUND Evidence demonstrates that parenteral administration of methotrexate (MTX) has a higher drug bioavailability with respect to the oral route of administration. This difference is even more pronounced for medium-to-high dosages.
OBJECTIVES To compare the efficacy, safety, and tolerability of oral and subcutaneous (SC) MTX for treatment of psoriasis.
METHODS A randomized, comparative, single-blind, 32-week study was conducted. The clinical response was evaluated using the Psoriasis Area Severity Index (PASI) and the patient global assessment was assessed using the Visual Analog Scale (VAS).
RESULTS Seventy-seven patients had completed the study, 38 in SC and 39 in oral MTX group. No significant between-group differences were found in PASI 75 (p=0.14, 0.21), PASI 90 (p=0.23, 0.18), and PASI 100 (p=0.62, 0.22) responses at week 16 and 32, respectively. The mean VAS, however, throughout the 32-week study according to the multivariable analysis showed that SC MTX was superior to oral MTX for patient evaluation of disease improvement. Adverse events were comparable in both groups.
CONCLUSIONS Subcutaneous and oral administration of MTX had similar efficacies in improving the PASI score even at the highest tolerable dose. The SC MTX group, however, had higher overall patient satisfaction than the oral MTX group. No difference in tolerability was found.
SOURCE : Clinical and Experimental Dermatology
OBJECTIVES To compare the efficacy, safety, and tolerability of oral and subcutaneous (SC) MTX for treatment of psoriasis.
METHODS A randomized, comparative, single-blind, 32-week study was conducted. The clinical response was evaluated using the Psoriasis Area Severity Index (PASI) and the patient global assessment was assessed using the Visual Analog Scale (VAS).
RESULTS Seventy-seven patients had completed the study, 38 in SC and 39 in oral MTX group. No significant between-group differences were found in PASI 75 (p=0.14, 0.21), PASI 90 (p=0.23, 0.18), and PASI 100 (p=0.62, 0.22) responses at week 16 and 32, respectively. The mean VAS, however, throughout the 32-week study according to the multivariable analysis showed that SC MTX was superior to oral MTX for patient evaluation of disease improvement. Adverse events were comparable in both groups.
CONCLUSIONS Subcutaneous and oral administration of MTX had similar efficacies in improving the PASI score even at the highest tolerable dose. The SC MTX group, however, had higher overall patient satisfaction than the oral MTX group. No difference in tolerability was found.
SOURCE : Clinical and Experimental Dermatology
posted by dermatica at
January 13, 2022
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