An open-label, randomised, parallel clinical research evaluating the safety and efficacy of methotrexate and apremilast in patients with moderate to severe palm plantar psoriasis.

Abstract

Comparing apremilast to methotrexate, many studies have produced conflicting results on
its efficacy and safety. Therefore, additional study is needed to determine how Apremilast
works in palmoplantar psoriasis.A randomised, prospective, parallel-group, open-label
study was conducted on patients with moderate to severe palmoplantar psoriasis. They
were randomised to either the apremilast group (n = 22) or the methotrexate group (n =
19) for a duration of 16 weeks. The main efficacy parameter was decreased scores on the
modified palmoplantar psoriasis severity index (mPPPASI) between weeks 0 and 16. The
proportion of patients who showed a dermatology life quality index decline of at least
5àpoints from the start, the percentage of patients who achieved mPPPASI75 (75%
reduction in mPPPASI score), and the percentage of patients who obtained a Static
Physician Global Assessment score of 0 (clear) or 1 (almost clear) were additional
metrics.Although there was a substantial reduction from week 0 to week 16 within the
group, there was no statistically significant difference in the drop in m-PPPASI scores
between the two groups at 16 weeks. The results of the secondary efficacy measures were
the same. Three people had abnormal liver function tests out of the twenty-four adverse
events reported in the methotrexate group. Two individuals had an upper respiratory tract
infection out of the 19 adverse events reported in the apremilast group.Apremilast is more
tolerated than methotrexate when used to treat moderate to severe palmoplantar
psoriasis. Static Physician Global Assessment, Dermatology Life Quality Index,
Palmoplantar Psoriasis, Palmoplantar Psoriasis Area and Severity Index, Apremilast.