2018, Vol. 1, Issue 2, Part A

Material and Methods: This comparative study included 60 patients who had been diagnosed with moderate-to-severe plaque psoriasis. The research took place from December 2017 through November 2018 at Narayana Medical College's Department of Dermatology in Chintareddypalem, Nellore, Andhra Pradesh, India. The psoriasis area and severity index were used to evaluate the severity of the condition, while the clinical examination was used to establish the diagnosis. Methotrexate was given to 30 patients in Group A, and Apremilast was given to 30 patients in Group B. The patients were randomly assigned to these groups. At baseline (0 months), as well as in the first, second, and fourth months of treatment, PASI scores were documented. Decreases in PASI scores over time were the main results.

Results: After one month, a substantial decrease in PASI scores was observed in 16 out of 18 patients in Group B with baseline scores more than 25, while only 14 out of 15 patients in Group A exhibited improvement. In Group A, 12 out of 15 patients had even lower PASI scores by the end of the second month. Ten of the twelve patients still alive in Group A attained a PASI 50 reaction by the fourth month, whereas fourteen of sixteen patients in Group B attained a PASI 75 response. Two individuals in Group A needed a higher dosage of Methotrexate to get a PASI 75 response.

Conclusion: Apremilast outperformed Methotrexate in terms of obtaining PASI 75 at the fourth month. If patients are monitored regularly for adverse effects, methotrexate is still a feasible and cost-effective therapeutic choice. If a patient does not get the best possible reduction in PASI with the usual Methotrexate dosage, it may be essential to increase the dosage.