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

Simple item page
dc.contributor.authorErduran F.
dc.contributor.authorEmre S.
dc.contributor.authorHayran Y.
dc.contributor.authorAdışen E.
dc.contributor.authorPolat A.K.
dc.contributor.authorÜstüner P.
dc.contributor.authorÖztürkcan S.
dc.contributor.authorÖztürk P.
dc.contributor.authorErmertcan A.T.
dc.contributor.authorSelçuk L.B.
dc.contributor.authorAksu E.K.
dc.contributor.authorAkbaş A.
dc.contributor.authorKalkan G.
dc.contributor.authorDemirseren D.
dc.contributor.authorKartal S.P.
dc.contributor.authorTopkarcı Z.
dc.contributor.authorKılıç A.
dc.contributor.authorYaldız M.
dc.contributor.authorAytekin S.
dc.contributor.authorHızlı P.
dc.contributor.authorGharehdaghi S.
dc.contributor.authorBorlu M.
dc.contributor.authorIşık L.
dc.contributor.authorBotsalı B.R.
dc.contributor.authorSolak E.Ö.
dc.contributor.authorAlbayrak H.
dc.contributor.authorGönülal M.
dc.contributor.authorBalcı D.D.
dc.contributor.authorPolat M.
dc.contributor.authorDaye M.
dc.contributor.authorAtaseven A.
dc.contributor.authorYıldız S.
dc.contributor.authorÖzer İ.
dc.contributor.authorZorlu Ö.
dc.contributor.authorDoğan S.
dc.contributor.authorErdemir V.A.
dc.contributor.authorDikicier B.S.
dc.date.accessioned2024-07-22T08:01:06Z
dc.date.available2024-07-22T08:01:06Z
dc.date.issued2024
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. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
dc.identifier.DOI-ID10.1007/s00403-024-03066-1
dc.identifier.issn03403696
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/11327
dc.language.isoEnglish
dc.publisherSpringer Nature
dc.subjectAdministration, Oral
dc.subjectAdult
dc.subjectDermatologic Agents
dc.subjectFemale
dc.subjectFolic Acid
dc.subjectHumans
dc.subjectInjections, Subcutaneous
dc.subjectMale
dc.subjectMethotrexate
dc.subjectMiddle Aged
dc.subjectPsoriasis
dc.subjectRetrospective Studies
dc.subjectSeverity of Illness Index
dc.subjectTreatment Outcome
dc.subjectacitretin
dc.subjectaminotransferase
dc.subjectbiological product
dc.subjectcyclosporine
dc.subjectfolic acid
dc.subjectmethotrexate
dc.subjectprocollagen
dc.subjectprocollagen 3 peptide
dc.subjecttopical agent
dc.subjectunclassified drug
dc.subjectdermatological agent
dc.subjectfolic acid
dc.subjectmethotrexate
dc.subjectadult
dc.subjectadverse drug reaction
dc.subjectaminotransferase blood level
dc.subjectanemia
dc.subjectArticle
dc.subjectclinical feature
dc.subjectcomorbidity
dc.subjectdrug withdrawal
dc.subjectfatigue
dc.subjectfemale
dc.subjectgastrointestinal symptom
dc.subjectheadache
dc.subjecthuman
dc.subjecthypertransaminasemia
dc.subjectinfection
dc.subjectleukopenia
dc.subjectliver fibrosis
dc.subjectlymphocytopenia
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmonotherapy
dc.subjectmucocutaneous disease
dc.subjectnausea and vomiting
dc.subjectphototherapy
dc.subjectPsoriasis Area and Severity Index
dc.subjectpsoriasis vulgaris
dc.subjectretrospective study
dc.subjectrisk factor
dc.subjectside effect
dc.subjectskin disease
dc.subjectsystemic therapy
dc.subjecttertiary care center
dc.subjecttransient elastography
dc.subjecttreatment duration
dc.subjecttreatment response
dc.subjectunspecified side effect
dc.subjectupper respiratory tract infection
dc.subjecturinary tract infection
dc.subjectvitamin supplementation
dc.subjectclinical trial
dc.subjectdiagnosis
dc.subjectdrug therapy
dc.subjectmiddle aged
dc.subjectmulticenter study
dc.subjectoral drug administration
dc.subjectpsoriasis
dc.subjectseverity of illness index
dc.subjectsubcutaneous drug administration
dc.subjecttreatment outcome
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

Files

Collections

Scopus Koleksiyonu