Journal of the European Academy of Dermatology and Venereology

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>There are limited data on the impact of the route of administration of methotrexate (MTX) on drug survival in psoriasis.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the impact of the initial route of administration of MTX (monotherapy) on drug survival in patients with moderate to severe skin psoriasis.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>A prospective cohort study based on the Psobioteq registry, included from July 2012 to January 2023, patients with plaque, erythrodermic or guttate psoriasis, naive to MTX, biologics and apremilast, who initiated MTX monotherapy. Factors associated with drug survival were identified using Kaplan–Meier curves and Cox regression analyses.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In total, 406 patients were included, 58.1% received MTX per os (MTX‐PO) and 41.9% subcutaneously (MTX‐SC). At MTX initiation, the median PASI score was 11, and 67.3% had DLQI ≥6. Adjusted drug survival did not statistically differ according to the route of administration (<jats:italic>p</jats:italic> = 0.15).</jats:p></jats:sec><jats:sec><jats:title>Limitations</jats:title><jats:p>Limited number of patients leading to a potential lack of power. Residual confounding cannot be waived due to the observational nature of the data.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Overall MTX survival did not significantly differ according to the route of administration. However, with MTX‐SC, the hazard of discontinuation for ineffectiveness was lower and of discontinuation for intolerance was higher than with MTX‐PO.</jats:p></jats:sec>

publication_history

received

accepted

published

Agence Nationale de Sécurité du Médicament et des Produits de Santé

AbbVie

Pfizer

Ministère de la Santé

Janssen Pharmaceutica

Amgen

Novartis

Celgene

LEO Pharma Research Foundation

Eli Lilly and Company

Merck

Psoriasis

Lancet

French guidelines on the use of systemic treatments for moderate‐to‐severe psoriasis in adults

J Eur Acad Dermatol Venereol

Effectiveness of subcutaneous methotrexate in chronic plaque psoriasis

J Drugs Dermatol

The comparative effectiveness of oral versus subcutaneous methotrexate for the treatment of early rheumatoid arthritis

Ann Rheum Dis

Drug survival and predictor factors for discontinuation of methotrexate in psoriasis: a real‐life multicenter study

Int J Dermatol

Comparison of the clinical efficacy and safety of subcutaneous versus oral administration of methotrexate in patients with active rheumatoid arthritis: results of a six‐month, multicenter, randomized, double‐blind, controlled, phase IV trial

Arthritis Rheum

Comparison of overall efficacy and safety of oral versus subcutaneous methotrexate in severe psoriasis

Dermatol Ther

Comparison of the clinical efficacy of subcutaneous vs. oral administration of methotrexate in patients with psoriasis vulgaris: a randomized controlled trial

Clin Exp Dermatol

Systemic methotrexate therapy for psoriasis: past, present and future

There are limited data on the impact of the route of administration of methotrexate (MTX) on drug survival in psoriasis.
To evaluate the impact of the initial route of administration of MTX (monotherapy) on drug survival in patients with moderate to severe skin psoriasis.
A prospective cohort study based on the Psobioteq registry, included from July 2012 to January 2023, patients with plaque, erythrodermic or guttate psoriasis, naive to MTX, biologics and apremilast, who initiated MTX monotherapy. Factors associated with drug survival were identified using Kaplan-Meier curves and Cox regression analyses.
In total, 406 patients were included, 58.1% received MTX per os (MTX-PO) and 41.9% subcutaneously (MTX-SC). At MTX initiation, the median PASI score was 11, and 67.3% had DLQI ≥6. Adjusted drug survival did not statistically differ according to the route of administration (p = 0.15).
Limited number of patients leading to a potential lack of power. Residual confounding cannot be waived due to the observational nature of the data.
Overall MTX survival did not significantly differ according to the route of administration. However, with MTX-SC, the hazard of discontinuation for ineffectiveness was lower and of discontinuation for intolerance was higher than with MTX-PO.

Impact of methotrexate administration route on drug survival in psoriasis: Results from PSOBIOTEQ.

Impact of methotrexate administration route on drug survival in psoriasis: Results from <scp>PSOBIOTEQ</scp>

Impact of methotrexate administration route on drug survival in psoriasis: Results from <scp>PSOBIOTEQ</scp>

Clinical Summary

What was studied

Key findings

Study limitations

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