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Weekly vs. daily administration of oral methotrexate (MTX) for generalized plaque psoriasis: a randomized controlled clinical trial.
Int J Dermatol. 2011 Oct; 50(10):1291-3.IJ

Abstract

Methotrexate (MTX) treatment for psoriasis is most often administered weekly, because the drug has been considered more hepatotoxic when taken daily. However, some patients may tolerate smaller, more frequent doses better.

OBJECTIVE

To study the efficacy and toxicity of daily vs. weekly MTX.

PATIENTS AND METHODS

In a randomized controlled trial, 101 patients with generalized plaque psoriasis received oral MTX 2.5 mg daily for weeks, 4 weeks and monthly for a total of 4 months. Changes in PASI scores were classified into three categories: >75% improvement was considered significant; 25-75% moderate; and <25% poor.

RESULTS

Sixty Group 1 patients and 81 Group 2 patients showed a significant response (P-value 0.001); 19 patients in Group 1 and 14 in Group 2 responded moderately; 22 patients in Group 1 and six patients from Group 2 responded poorly. Forty-five patients in Group 1 and 33 in Group 2 developed transient increases in liver enzymes (P-value 0.11). Nausea, headache, fatigue, and gastrointestinal upset were noted in four Group 1 patients and 30 Group 2 patients (P-value 0.0001).

CONCLUSION

Nausea, vomiting, headache, and fatigue were significantly less common side effects in our patients who received MTX daily, but liver enzyme abnormalities were less common, and clinical efficacy was greater in the patients who received MTX weekly.

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Authors+Show Affiliations

Radmanesh M
Department of Dermatology, Jondishapour University of Medical Sciences, Ahvaz, Iran. radmanesh_m@yahoo.com
Rafiei B
No affiliation info available
Moosavi ZB
No affiliation info available
Sina N
No affiliation info available

MeSH

AdolescentAdultAgedBlood Cell CountBlood Urea NitrogenCreatinineDermatologic AgentsDrug Administration ScheduleFatigueFemaleHeadacheHumansLiver Function TestsMaleMethotrexateMiddle AgedNauseaPsoriasisSeverity of Illness IndexTreatment OutcomeVomitingYoung Adult

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

21950300

Citation

Radmanesh, Mohammad, et al. "Weekly Vs. Daily Administration of Oral Methotrexate (MTX) for Generalized Plaque Psoriasis: a Randomized Controlled Clinical Trial." International Journal of Dermatology, vol. 50, no. 10, 2011, pp. 1291-3.
Radmanesh M, Rafiei B, Moosavi ZB, et al. Weekly vs. daily administration of oral methotrexate (MTX) for generalized plaque psoriasis: a randomized controlled clinical trial. Int J Dermatol. 2011;50(10):1291-3.
Radmanesh, M., Rafiei, B., Moosavi, Z. B., & Sina, N. (2011). Weekly vs. daily administration of oral methotrexate (MTX) for generalized plaque psoriasis: a randomized controlled clinical trial. International Journal of Dermatology, 50(10), 1291-3. https://doi.org/10.1111/j.1365-4632.2011.04967.x
Radmanesh M, et al. Weekly Vs. Daily Administration of Oral Methotrexate (MTX) for Generalized Plaque Psoriasis: a Randomized Controlled Clinical Trial. Int J Dermatol. 2011;50(10):1291-3. PubMed PMID: 21950300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Weekly vs. daily administration of oral methotrexate (MTX) for generalized plaque psoriasis: a randomized controlled clinical trial. AU - Radmanesh,Mohammad, AU - Rafiei,Behnam, AU - Moosavi,Zahra-Beigum, AU - Sina,Niloofar, PY - 2011/9/29/entrez PY - 2011/9/29/pubmed PY - 2012/2/2/medline SP - 1291 EP - 3 JF - International journal of dermatology JO - Int J Dermatol VL - 50 IS - 10 N2 - UNLABELLED: Methotrexate (MTX) treatment for psoriasis is most often administered weekly, because the drug has been considered more hepatotoxic when taken daily. However, some patients may tolerate smaller, more frequent doses better. OBJECTIVE: To study the efficacy and toxicity of daily vs. weekly MTX. PATIENTS AND METHODS: In a randomized controlled trial, 101 patients with generalized plaque psoriasis received oral MTX 2.5 mg daily for weeks, 4 weeks and monthly for a total of 4 months. Changes in PASI scores were classified into three categories: >75% improvement was considered significant; 25-75% moderate; and <25% poor. RESULTS: Sixty Group 1 patients and 81 Group 2 patients showed a significant response (P-value 0.001); 19 patients in Group 1 and 14 in Group 2 responded moderately; 22 patients in Group 1 and six patients from Group 2 responded poorly. Forty-five patients in Group 1 and 33 in Group 2 developed transient increases in liver enzymes (P-value 0.11). Nausea, headache, fatigue, and gastrointestinal upset were noted in four Group 1 patients and 30 Group 2 patients (P-value 0.0001). CONCLUSION: Nausea, vomiting, headache, and fatigue were significantly less common side effects in our patients who received MTX daily, but liver enzyme abnormalities were less common, and clinical efficacy was greater in the patients who received MTX weekly. SN - 1365-4632 UR - https://www.unboundmedicine.com/medline/citation/21950300/Weekly_vs__daily_administration_of_oral_methotrexate__MTX__for_generalized_plaque_psoriasis:_a_randomized_controlled_clinical_trial_ L2 - https://doi.org/10.1111/j.1365-4632.2011.04967.x DB - PRIME DP - Unbound Medicine ER -