Etanercept versus Methotrexate in the Treatment of Psoriasis and Associated Metabolic Syndrome: 12-Month Open-Label Comparative Study.

IF 3 3区医学 Q2 DERMATOLOGY

Dermatology Pub Date : 2024-07-29 DOI:10.1159/000540589

Samer A Dhaher, Jinan Q Mohammed

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Abstract

Introduction: Psoriasis is a chronic inflammatory systemic disease accompanied by systemic damage that leads to the development of multiple comorbidities including metabolic syndrome. Conventional systemic therapies for psoriasis are associated with toxicity and have a greater burden on the patients. The study aimed to assess the effectiveness of etanercept (ETN) monotherapy in comparison with methotrexate (MTX) monotherapy.

Methods: In this prospective interventional comparative open-label study, 117 patients with psoriasis were randomized to 2 groups; 1 group of 42 patients; 32 (67.2%) males and 10 (23.8%) females treated with MTX, and the second group of 75 patients; 54 (72%) males and 21 (28%) females treated with ETN. Full laboratory investigations, body mass index (BMI), measurement of skin disease severity which was performed using Psoriasis Area Severity Index (PASI), and the reduction of 75% of the skin lesions (PASI 75) were calculated for all participants.

Results: In the MTX group, there were no significant differences in BMI, or blood pressure after 12 weeks of the study. There is a reduction in the values of FBS, TSC, LDL, TRIG, ESR, CRP, and PASI, but this reduction was statistically not significant. Ten (23.8%) patients achieved PASI 75. In the ETN group, except for BMI, systolic and diastolic blood pressure, all other metabolic syndrome components, inflammatory markers, and PASI were decreased; the reduction was statistically significant. Sixty (80%) patients achieved PASI 75.

Conclusion: Etanercept monotherapy showed greater efficacy than MTX monotherapy in the treatment of moderate to severe plaque-type psoriasis as it achieved greater reductions in PASI score and greater achievement of PASI 75 after 12 weeks. Etanercept monotherapy showed greater efficacy than MTX monotherapy in the improvement of all components of the associated metabolic syndrome except for BMI, which was increased in etanercept-treated patients.

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依那西普与甲氨蝶呤治疗银屑病及相关代谢综合征：12 个月开放标签比较研究。

背景：银屑病是一种慢性炎症性全身性疾病，伴有全身性损害，导致包括代谢综合征在内的多种并发症的发生。银屑病的传统系统疗法与毒性相关，给患者带来更大负担。该研究旨在评估依那西普（ETN）单一疗法与甲氨蝶呤（MTX）单一疗法的有效性：在这项前瞻性介入对比开放标签研究中，117名银屑病患者被随机分为两组：一组42人，其中32人（67.2%）为男性，10人（23.8%）为女性，接受MTX治疗；另一组75人，其中54人（72%）为男性，21人（28%）为女性，接受ETN治疗。所有参与者都接受了全面的实验室检查、体重指数（BMI）、使用银屑病面积严重性指数（PASI）测量皮肤病严重程度，并计算了皮损减少 75% 的情况（PASI 75）：研究 12 周后，MTX 组的体重指数和血压没有明显差异。FBS、TSC、LDL、TRIG、ESR、CRP 和 PASI 的值有所下降，但下降幅度在统计学上并不显著。有 10 名患者（23.8%）的 PASI 达到 75。在 ETN 组中，除体重指数、收缩压和舒张压外，所有其他代谢综合征成分、炎症指标和 PASI 均有所下降；下降幅度在统计学上有显著意义。60例（80%）患者的PASI达到75：结论：在治疗中度至重度斑块型银屑病方面，依那西普单一疗法优于甲氨蝶呤单一疗法，因为在12周后，依那西普的PASI评分降低幅度更大，PASI达到75的比例更高。在改善相关代谢综合征的所有组成部分方面，依那西普单一疗法优于甲氨蝶呤单一疗法，但体重指数（BMI）除外，接受依那西普治疗的患者体重指数会升高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatology 医学-皮肤病学

CiteScore

6.40

自引率

2.90%

发文量

审稿时长

1 months

期刊介绍： Published since 1893, ''Dermatology'' provides a worldwide survey of clinical and investigative dermatology. Original papers report clinical and laboratory findings. In order to inform readers of the implications of recent research, editorials and reviews prepared by invited, internationally recognized scientists are regularly featured. In addition to original papers, the journal publishes rapid communications, short communications, and letters to ''Dermatology''. ''Dermatology'' answers the complete information needs of practitioners concerned with progress in research related to skin, clinical dermatology and therapy. The journal enjoys a high scientific reputation with a continually increasing impact factor and an equally high circulation.