Analysis of factors influencing target PASI responses and side effects of methotrexate monotherapy in plaque psoriasis: a multicenter study of 1521 patients

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dc.authoridOKSUM SOLAK, EDA/0000-0002-1362-7801
dc.authoridDemirseren, Duriye Deniz/0000-0002-4480-7792
dc.authoridKartal, Selda Pelin/0000-0001-7310-8635
dc.contributor.authorErduran, Funda
dc.contributor.authorEmre, Selma
dc.contributor.authorHayran, Yildiz
dc.contributor.authorAdisen, Esra
dc.contributor.authorPolat, Asude Kara
dc.contributor.authorUstuner, Pelin
dc.contributor.authorOzturkcan, Serap
dc.date.accessioned2024-10-29T17:58:18Z
dc.date.available2024-10-29T17:58:18Z
dc.date.issued2024
dc.departmentTekirdağ Namık Kemal Üniversitesi
dc.description.abstractMethotrexate (MTX) is commonly used as first-line systemic treatment agent in psoriasis. We aimed to evaluate the clinical characteristics and treatment responses of patients with psoriasis undergoing MTX monotherapy. Data from adult patients with plaque psoriasis who received MTX monotherapy for at least 3 months between April 2012 and April 2022 were retrospectively evaluated in 19 tertiary care centers. Our study included 722 female and 799 male patients, a total of 1521 participants. The average age of the patients was 44.3 +/- 15.5 years. Mode of treatment was oral in 20.4% of patients while in 79.4% it was subcutaneous. The median treatment duration was 8 months (IQR = 5-15). The median weekly dose was 15 mg (IQR = 11-15). 1448 (95.2%) patients were taking folic acid supplementation. At week 12, 16.3% of the patients achieved PASI (Psoriasis Area and Severity Index) 90 response while at week 24, 37.3% achieved it. Logistic regression analysis for week 12 identified the following independent factors affecting PASI 90 achievement positively: median weekly MTX dose <= 15 mg (P = 0.011), subcutaneous administration (P = 0.005), no prior systemic treatment (< 0.001) and folic acid use (0.021). In logistic regression analysis for week 24; median weekly MTX dose <= 15 mg (P = 0.001), baseline PASI >= 10 (P < 0.001), no prior systemic treatment (P < 0.004), folic acid use (P = 0.001) and absence of comorbidities (P = 0.009) were determined as independent factors affecting the achievement of PASI 90. Adverse effects were observed in 38.8% of the patients, with nausea/vomiting (23.9%) and transaminase elevation (13%) being the most common. The most common reasons for interruptions (15.3%) and discontinuations (27.1%) of the treatment were patient related individual factors. The use of MTX as the first systemic treatment agent, at doses <= 15 mg/week and concurrent folic acid application are positive predictive factors for achieving the target PASI response both at weeks 12 and 24. In our study, which is one of the most comprehensive studies on MTX treatment in psoriasis, we observed that MTX is an effective and safe treatment option.
dc.identifier.doi10.1007/s00403-024-03066-1
dc.identifier.issn0340-3696
dc.identifier.issn1432-069X
dc.identifier.issue6en_US
dc.identifier.pmid38796658
dc.identifier.scopus2-s2.0-85194427783
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1007/s00403-024-03066-1
dc.identifier.urihttps://hdl.handle.net/20.500.11776/14203
dc.identifier.volume316
dc.identifier.wosWOS:001233071900054
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofArchives of Dermatological Research
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectPsoriasis
dc.subjectMethotrexate
dc.subjectSubcutaneous
dc.subjectPASI 90
dc.subjectSide effects
dc.titleAnalysis of factors influencing target PASI responses and side effects of methotrexate monotherapy in plaque psoriasis: a multicenter study of 1521 patients
dc.typeArticle

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