Efficacy and safety of mycophenolate mofetil vs. methotrexate for the treatment of chronic plaque psoriasis.
BACKGROUND
Methotrexate (MTX) is a well-known systemic drug for moderate to severe chronic plaque psoriasis. Recently, mycophenolate mofetil (MMF) has been recommended for psoriasis.


OBJECTIVE
To compare the efficacy and safety of MMF vs. MTX for the treatment of chronic plaque psoriasis.


METHODS
Thirty-eight consecutive patients with Psoriasis Area and Severity Index (PASI)>10 were randomly assigned for 12 weeks of treatment with either MTX (18 patients; initial dose, 7.5 mg/week) or MMF (20 patients; dose; 2 g/day) and were followed for 12 weeks after discontinuing the treatment. The differences between the two groups were analysed at the end of treatment and follow-up comparing with baseline values.


RESULTS
After 12 weeks of treatment, the mean ± SD score for the PASI decreased from 16.46 ± 5.29 at baseline to 3.17 ± 2.35 among 15 patients treated with MTX, whereas the score decreased from 17.43 ± 7.42 to 3.97 ± 5.95 among 17 patients treated with MMF (P>0.05). Twelve weeks after discontinuing the treatment, the scores were 4.77 ± 3.52 and 5.94 ± 4.27, respectively (P>0.05). PASI -75 were achieved in 58.8% of patients in MMF group and 73.3% in MTX group (P > 0.05). Three months after discontinuing the treatment, PASI-75 remained in 33.3% of patients in MMF and 53.3% of MTX group (P > 0.05). Both drugs were well tolerated and side-effects were minor and transient.


CONCLUSIONS
No significant differences in efficacy were found between MTX and MMF groups. MMF may represent a good alternative for the treatment of psoriasis in patients who are unable to take MTX or other available drugs due to contraindication or toxicity.
Akhyani
M
M
Department of Dermatology, Razi Hospital, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Chams-Davatchi
C
C
Hemami
M R
MR
Fateh
S
S
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
D003879:Dermatologic Agents; D009173:Mycophenolic Acid; D008727:Methotrexate