COMPARATIVE STUDY ON EFFICACY, SAFETY AND TOLERABILITY OF ETANERCEPT AND PARENTERAL METHOTREXATE IN CHRONIC STABLE PLAQUE PSORIASIS

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COMPARATIVE STUDY ON EFFICACY, SAFETY AND TOLERABILITY OF ETANERCEPT AND PARENTERAL METHOTREXATE IN CHRONIC STABLE PLAQUE PSORIASIS

Journal Title: Stanley Medical Journal - Year 2017, Vol 4, Issue 1

Abstract

Context: Psoriasis is a complex papulosquamous disorder of multifactorial etiology. Treatment modalities for psoriasis are often selected based on the severity of disease, associated co-morbidities, efficacy and patient preference. Etanercept is a TNF- alpha inhibitor. It acts by binding to both membrane bound and soluble TNF- alpha and hence prevents the cytokine from binding to any cell surface receptors. methotrexate is an antimetabolite and a folic acid analogue , acting as a competitive inhibitor for folate receptors and has an excellent therapeutic effect for the control of psoriasis.(1-4) Aims: 1. To compare the efficacy, safety and tolerability of etanercept 50mg S.C/week versus methotrexate 25mg I.M /week. 2. To observe for adverse effects during and after treatment. Settings and design: It was a randomized, prospective, open label, parallel group study. Methods & material:Place of study: Govt Stanley Medical College, Chennai Time duration: One year (June 2012 To June 2013) . Sample size: 2 groups, each containing 20 patients . Statistical analysis used: Descriptive statistics frequency analysis, percentage analysis, mean, standard deviation were used to describe the data,. To find the significance, difference between the bivariate samples Independent t-test was used. For the multivariate analysis the repeated measures was used and for categorical values Chi-Square test was used. In all the above statistical tools the probability value P=.05 WAs considered as significant level. Results: In our study 65% of patients treated with Inj. Etanercept at a dose of 50 mg/week achieved PASI 75 at week 12. The mean remission period in this group was three months. No significant haematological or systemic adverse effects were noted during the study. In those who received Inj. Methotrexate 25mg I.M per week(cumulative dose of 300mg), at week 12, PASI 75 was achieved by 50% of patients, whereas 65% of patients had achieved a minimum of PASI 50 . The average duration of remission in this group was two months. The mean decrease in PASI score at week 12 was 56.5 %. Conclusions: In our study Inj. Etanercept 50mg/week was more efficacious than Inj. Methotrexate 25mg/wk in achieving PASI 75 at week 12[65% Vs 50%] [N=40]. Inj. Etanercept. KEY MESSAGES: Etanercept is more efficacious, safer with longer remission period than methotrexate. But long term studies for the assessment of risk benefit ratio is not available. was safer and the remission period in this group was prolonged compared to Inj.Methotrexate

Authors and Affiliations

Senthil kumar V, Anandan V, Kopika S

Keywords

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EP ID EP217396
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