Clinical improvement of patients with moderate-to-severe psoriasis treated with methotrexate at Dr. Soetomo General Hospital, Surabaya, Indonesia

Made Putri Hendaria; Afif Nurul Hidayati; Evy Ervianti; Muhammad Yulianto Listiawan; Damayanti; Irmadita Citrashanty; Sylvia Anggraeni; Menul Ayu Umborowati; Budi Utomo; Cita Rosita Sigit Prakoeswa

doi:10.15562/bmj.v11i1.3417

Clinical improvement of patients with moderate-to-severe psoriasis treated with methotrexate at Dr. Soetomo General Hospital, Surabaya, Indonesia

Made Putri Hendaria ,

Afif Nurul Hidayati ,

Evy Ervianti ,

Muhammad Yulianto Listiawan ,

Damayanti ,

Irmadita Citrashanty ,

Sylvia Anggraeni ,

Menul Ayu Umborowati ,

Budi Utomo ,

Cita Rosita Sigit Prakoeswa ,

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DOI: https://doi.org/10.15562/bmj.v11i1.3417 |
Published: 2022-04-21

Abstract

Background: Psoriasis is a complex, chronic disease with increasing global incidence. Studies on the effectiveness of psoriasis therapy in Indonesia are limited. This study aimed to evaluate the patient’s clinical improvement with moderate-to-severe psoriasis vulgaris using the Psoriasis Area and Severity Index with ≥75% score reduction (PASI75).

Methods: This is a retrospective study involving patients diagnosed with psoriasis vulgaris who visited the Dermatology and Venereology Outpatient Clinic in Dr. Soetomo General Hospital between January 2016 and December 2018. The electronic medical record obtained data on demographic characteristics, the number of visits, psoriasis at initial (PASI) score before and after treatment, type and dose of treatment, and comorbidities. Data were analyzed using SPSS version 23 for Windows.

Results: Overall, 54 patients with psoriasis vulgaris were included. Almost all subjects were adults (≥18 years old) and presented with severe PASI (PASI score > 10) (96.3%). The majority of the subjects (64.8%) successfully achieved PASI75. Most subjects received methotrexate (72.2%); the most frequent dosage was 15 mg/week (61.5%). A significant association was found between methotrexate treatment and a larger improvement in PASI scores (p=0.001).

Conclusion: moderate-to-severe psoriasis therapy in terms of PASI75 achieved a satisfactory success rate of 64.8%, and the improvement of PASI score was significantly better in patients who received methotrexate. Further studies in Indonesia are needed to explore the effectiveness of psoriasis therapy and its factors.

References

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Adiguna MS, Rusyati LMM, Sudarsa PSS. Correlation of plasma vitamin d receptors with the severity of psoriasis vulgaris. Bali Medical Journal. 2020;9(3):668-671.
Sinniah B, Saraswathy Devi S, Prashant BS. Epidemiology of psoriasis in malaysia: a hospital based study. Med J Malaysia. 2010;65(2):112- 114.
Zhang JZ. Epidemiology and risk factors of psoriasis. Pract J Clin Med. 2013;1(1):4-6.
Gayatri L. Studi retrospektif: psoriasis pustulosa generalisata. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2014;26(1):49-55.
Palfreeman AC, McNamee KE, McCann FE. New developments in the management of psoriasis and psoriatic arthritis: a focus on apremilast. Drug Des Devel Ther. 2013;7:201- 210.
Armstrong AW, Read C. Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review. JAMA. 2020;323(19):1945- 1960.
Kim WB, Jerome D, Yeung J. Diagnosis and management of psoriasis. Can Fam Physician. 2017;63(4):278-285.
Burfield L, Burden AD. Psoriasis. J R Coll Physicians Edinb. 2013;43(4):334-339. doi:10.4997/JRCPE.2013.414
Xhaja A, Shkodrani E, Frangaj S, Kuneshka L, Vasili E. An epidemiological study on trigger factors and quality of life in psoriatic patients. Mater Sociomed. 2014;26(3):168-171.
El-Komy MHM, Mashaly H, Sayed KS, Hafez V, El-Mesidy MS, Said ER, et al. Clinical and epidemiologic features of psoriasis patients in an Egyptian medical center. JAAD Int. 2020;1(2):81-90.
Ferreli C, Pinna AL, Pilloni L, Tomasini CF, Rongioletti F. Histopathological aspects of psoriasis and its uncommon variants. G Ital Dermatol Venereol. 2018;153(2):173-184.
Oliveira Mde F, Rocha Bde O, Duarte GV. Psoriasis: classical and emerging comorbidities. An Bras Dermatol. 2015;90(1):9-20.
Hernández-Fernández CP, Carretero G, Rivera R, Ferrándiz C, Daudén E, de Cueva P, et al. Effect of Sex in Systemic Psoriasis Therapy: Differences in Prescription, Effectiveness and Safety in the BIOBADADERM Prospective Cohort. Acta Derm Venereol. 2021;101(1):adv00354.
Gisondi P, Del Giglio M, Girolomoni G. Treatment Approaches to Moderate to Severe Psoriasis. Int J Mol Sci. 2017;18(11):2427.
Grabarek BO, Krzaczyński J, Strzałka- Mrozik B, Wcisło-Dziadecka D. An analysis of selected factors influencing the efficacy of psoriasis therapy. Przeglad Dermatologiczny. 2019;106(6):603–614.
Maul JT, Augustin M, Sorbe C, Conrad C, Anzengruber F, Mrowietz U, et al. Association of sex and systemic therapy treatment outcomes in psoriasis: a two-country, multicentre, prospective, noninterventional registry study. Br J Dermatol. 2021 Dec;185(6):1160-1168.
Højgaard P, Ballegaard C, Cordtz R, Zobbe K, Clausen M, Glintborg B, et al. Gender differences in biologic treatment outcomes-a study of 1750 patients with psoriatic arthritis using Danish Health Care Registers. Rheumatology (Oxford). 2018;57(9):1651-1660.
Mason KJ, Williams S, Yiu ZZN, McElhone K, Ashcroft DM, Kleyn CE, et al. Persistence and effectiveness of nonbiologic systemic therapies for moderate-to-severe psoriasis in adults: a systematic review. Br J Dermatol. 2019;181(2):256-264.
van Winden MEC, van der Schoot LS, van de L’Isle Arias M, van Vugt LJ, van den Reek JMPA, van de Kerkhof PCM. Effectiveness and safety of systemic therapy for psoriasis in older adults: a systematic review. JAMA Dermatol. 2020;156(11):1229-1239.
Prieto-Pérez R, Cabaleiro T, Daudén E, Ochoa D, Román M, Abad-Santos F. Pharmacogenetics of topical and systemic treatment of psoriasis. Pharmacogenomics. 2013;14(13):1623–1634.
Prabawa IPY, Lestari AAW, Muliarta IM, Mardhika PE, Pertiwi GAR, Bhargah A, et al. The Stromal Cell-derived Factor-1/CXCL12 3’A-gene Polymorphism is Related to the Increased Risk of Coronary Artery Disease: A Systematic Review and Meta-analysis. Open Access Macedonian Journal of Medical Sciences. 2020;8(F):197-202.
Ovejero-Benito MC, Muñoz-Aceituno E, Reolid A, Saiz-Rodríguez M, Abad-Santos F, Daudén E. Pharmacogenetics and Pharmacogenomics in Moderate-to-Severe Psoriasis. Am J Clin Dermatol. 2018;19(2):209-222.

[1] Boehncke WH, Schön MP. Psoriasis. Lancet. 2015;386(9997):983-994.

[2] Adiguna MS, Rusyati LMM, Sudarsa PSS. Correlation of plasma vitamin d receptors with the severity of psoriasis vulgaris. Bali Medical Journal. 2020;9(3):668-671.

[3] Sinniah B, Saraswathy Devi S, Prashant BS. Epidemiology of psoriasis in malaysia: a hospital based study. Med J Malaysia. 2010;65(2):112- 114.

[4] Zhang JZ. Epidemiology and risk factors of psoriasis. Pract J Clin Med. 2013;1(1):4-6.

[5] Gayatri L. Studi retrospektif: psoriasis pustulosa generalisata. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2014;26(1):49-55.

[6] Palfreeman AC, McNamee KE, McCann FE. New developments in the management of psoriasis and psoriatic arthritis: a focus on apremilast. Drug Des Devel Ther. 2013;7:201- 210.

[7] Armstrong AW, Read C. Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review. JAMA. 2020;323(19):1945- 1960.

[8] Kim WB, Jerome D, Yeung J. Diagnosis and management of psoriasis. Can Fam Physician. 2017;63(4):278-285.

[9] Burfield L, Burden AD. Psoriasis. J R Coll Physicians Edinb. 2013;43(4):334-339. doi:10.4997/JRCPE.2013.414

[10] Xhaja A, Shkodrani E, Frangaj S, Kuneshka L, Vasili E. An epidemiological study on trigger factors and quality of life in psoriatic patients. Mater Sociomed. 2014;26(3):168-171.

[11] El-Komy MHM, Mashaly H, Sayed KS, Hafez V, El-Mesidy MS, Said ER, et al. Clinical and epidemiologic features of psoriasis patients in an Egyptian medical center. JAAD Int. 2020;1(2):81-90.

[12] Ferreli C, Pinna AL, Pilloni L, Tomasini CF, Rongioletti F. Histopathological aspects of psoriasis and its uncommon variants. G Ital Dermatol Venereol. 2018;153(2):173-184.

[13] Oliveira Mde F, Rocha Bde O, Duarte GV. Psoriasis: classical and emerging comorbidities. An Bras Dermatol. 2015;90(1):9-20.

[14] Hernández-Fernández CP, Carretero G, Rivera R, Ferrándiz C, Daudén E, de Cueva P, et al. Effect of Sex in Systemic Psoriasis Therapy: Differences in Prescription, Effectiveness and Safety in the BIOBADADERM Prospective Cohort. Acta Derm Venereol. 2021;101(1):adv00354.

[15] Gisondi P, Del Giglio M, Girolomoni G. Treatment Approaches to Moderate to Severe Psoriasis. Int J Mol Sci. 2017;18(11):2427.

[16] Grabarek BO, Krzaczyński J, Strzałka- Mrozik B, Wcisło-Dziadecka D. An analysis of selected factors influencing the efficacy of psoriasis therapy. Przeglad Dermatologiczny. 2019;106(6):603–614.

[17] Maul JT, Augustin M, Sorbe C, Conrad C, Anzengruber F, Mrowietz U, et al. Association of sex and systemic therapy treatment outcomes in psoriasis: a two-country, multicentre, prospective, noninterventional registry study. Br J Dermatol. 2021 Dec;185(6):1160-1168.

[18] Højgaard P, Ballegaard C, Cordtz R, Zobbe K, Clausen M, Glintborg B, et al. Gender differences in biologic treatment outcomes-a study of 1750 patients with psoriatic arthritis using Danish Health Care Registers. Rheumatology (Oxford). 2018;57(9):1651-1660.

[19] Mason KJ, Williams S, Yiu ZZN, McElhone K, Ashcroft DM, Kleyn CE, et al. Persistence and effectiveness of nonbiologic systemic therapies for moderate-to-severe psoriasis in adults: a systematic review. Br J Dermatol. 2019;181(2):256-264.

[20] van Winden MEC, van der Schoot LS, van de L’Isle Arias M, van Vugt LJ, van den Reek JMPA, van de Kerkhof PCM. Effectiveness and safety of systemic therapy for psoriasis in older adults: a systematic review. JAMA Dermatol. 2020;156(11):1229-1239.

[21] Prieto-Pérez R, Cabaleiro T, Daudén E, Ochoa D, Román M, Abad-Santos F. Pharmacogenetics of topical and systemic treatment of psoriasis. Pharmacogenomics. 2013;14(13):1623–1634.

[22] Prabawa IPY, Lestari AAW, Muliarta IM, Mardhika PE, Pertiwi GAR, Bhargah A, et al. The Stromal Cell-derived Factor-1/CXCL12 3’A-gene Polymorphism is Related to the Increased Risk of Coronary Artery Disease: A Systematic Review and Meta-analysis. Open Access Macedonian Journal of Medical Sciences. 2020;8(F):197-202.

[23] Ovejero-Benito MC, Muñoz-Aceituno E, Reolid A, Saiz-Rodríguez M, Abad-Santos F, Daudén E. Pharmacogenetics and Pharmacogenomics in Moderate-to-Severe Psoriasis. Am J Clin Dermatol. 2018;19(2):209-222.

Clinical improvement of patients with moderate-to-severe psoriasis treated with methotrexate at Dr. Soetomo General Hospital, Surabaya, Indonesia

Abstract

References

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