The efficacy and safety of methotrexate and intermittent cyclosporine therapy in extensive chronic plaque psoriasis: A randomized, double-blind, and comparative study

Background: Psoriasis vulgaris is common papulosquamous disorder. Methotrexate (MTX) and cyclosporine, both of these drugs are in regular use for psoriasis management. But which one is superior in efficacy are yet to establish. Aims and Objectives: The aim of the study was to compare efficacy of MTX and intermittent cyclosporine therapy in the management of extensive/severe psoriasis, and to find and compare the incidence of adverse effects/safety of both the drugs. Materials and Methods: A randomized and controlled study was designed to compare the efficacy and safety of treatment. Patients with extensive psoriasis were randomly put in two groups –MTX and cyclosporine group and treated for 12 weeks. Results: Psoriasis area severity index (PASI) gradually reduced in both group, that is, up to second visit of study, (4 Weeks after induction of study) the reduction was at par. After that, it reduced in Cyclosporine group significantly faster than MTX group. At the end of the study, that is, after 12 weeks, the difference of PASI in both groups was not significant. Side-effects were not serious and minimal. Conclusion: Both the drugs are effective, but Cyclosporine is faster in onset than MTX. Adverse effects are nominal and not serious.