OBJECTIVE: To compare the clinical efficacy of methotrexate (MTX) vs. fumaric acid esters (FAE) in psoriasis treated under daily life conditions. METHODS: Data were extracted from a registry (http://www.psoriasisregistry.at) of 272 adult patients with moderate-to-severe chronic plaque psoriasis treated primarily with MTX (n = 72) or FAE (n = 200) between 2004 and 2011. Data from all patients, including those who did not complete at least 3 months of monotherapy, were included in an intention-to-treat (ITT) worst-case analysis. RESULTS: Thirty of 72 (41.7%) patients treated with MTX and 85 of 200 (42.5%) patients treated with FAE discontinued early, mainly due to side-effects or lack of response. Among patients who completed at least 3 months of treatment, the response to primary treatment with MTX vs. FAE did not differ significantly at any time point. In the ITT worst-case analysis at month 3, complete remission rate, PASI90, PASI75 and PASI50 rates were 6%, 7%, 24% and 39% in MTX-treated patients vs. 1%, 5%, 27% and 44% in FAE-treated patients. Overall mean PASI reduction score improved significantly in response to primary MTX and FAE treatment (by 10.6% and 12.6%, respectively) between 3 and 6 months (P = 0.0005; exact Wilcoxon test), but not between 6 and 12 months (P = 0.16). A subset of 32 patients who did not respond satisfactorily to primary treatment with FAE responded better to subsequent MTX therapy (P < 0.0001; paired Wilcoxon test). CONCLUSIONS: As shown by retrospective analysis, the primary efficacy of FAE was similar to that of MTX under daily life conditions.
OBJECTIVE: To compare the clinical efficacy of methotrexate (MTX) vs. fumaric acid esters (FAE) in psoriasis treated under daily life conditions. METHODS: Data were extracted from a registry (http://www.psoriasisregistry.at) of 272 adult patients with moderate-to-severe chronic plaque psoriasis treated primarily with MTX (n = 72) or FAE (n = 200) between 2004 and 2011. Data from all patients, including those who did not complete at least 3 months of monotherapy, were included in an intention-to-treat (ITT) worst-case analysis. RESULTS: Thirty of 72 (41.7%) patients treated with MTX and 85 of 200 (42.5%) patients treated with FAE discontinued early, mainly due to side-effects or lack of response. Among patients who completed at least 3 months of treatment, the response to primary treatment with MTX vs. FAE did not differ significantly at any time point. In the ITT worst-case analysis at month 3, complete remission rate, PASI90, PASI75 and PASI50 rates were 6%, 7%, 24% and 39% in MTX-treated patients vs. 1%, 5%, 27% and 44% in FAE-treated patients. Overall mean PASI reduction score improved significantly in response to primary MTX and FAE treatment (by 10.6% and 12.6%, respectively) between 3 and 6 months (P = 0.0005; exact Wilcoxon test), but not between 6 and 12 months (P = 0.16). A subset of 32 patients who did not respond satisfactorily to primary treatment with FAE responded better to subsequent MTX therapy (P < 0.0001; paired Wilcoxon test). CONCLUSIONS: As shown by retrospective analysis, the primary efficacy of FAE was similar to that of MTX under daily life conditions.
Authors: Paul Sator; Robert Loewe; Omid Zamani; Gregor Holzer; Peter Wolf; Alexander Mlynek; Thomas Berger; Leo Richter; Elisabeth Schuller Journal: Wien Klin Wochenschr Date: 2019-10-07 Impact factor: 1.704
Authors: Thomas Graier; Wolfgang Weger; Paul-Gunther Sator; Wolfgang Salmhofer; Barbara Gruber; Constanze Jonak; Claudia Kölli; Martina Schütz-Bergmayr; Igor Vujic; Gudrun Ratzinger; Nina Häring; Clemens Painsi; Knut Prillinger; Alexander Mlynek; Hans Skvara; Hannes Trattner; Adrian Tanew; Roland Lichem; Christina Ellersdorfer; Franz Legat; Alexandra Gruber-Wackernagel; Angelika Hofer; Erich Schmiedberger; Wolfram Hoetzenecker; Robert Müllegger; Werner Saxinger; Franz Quehenberger; Peter Wolf Journal: JAAD Int Date: 2020-12-26
Authors: K J Mason; S Williams; Z Z N Yiu; K McElhone; D M Ashcroft; C E Kleyn; Z K Jabbar-Lopez; C M Owen; N J Reynolds; C H Smith; N Wilson; R B Warren; C E M Griffiths Journal: Br J Dermatol Date: 2019-03-27 Impact factor: 9.302