Reynoso DC, Reyes MC, Rodríguez MN, Martínez AE, González OM, Robles CJA, Hernández SE

Language: Spanish
References: 10
Page: 122-124
PDF size: 362.35 Kb.

ABSTRACT

Introduction: Psoriasis is a multifactorial skin disease in which there is a chronic inflammatory process triggered by multiple cytokines. Thiazolidinediones are agonists of the peroxisome proliferator-activated receptor and have showed improvement in psoriasis patients with diabetes mellitus. It is possible that inhibition of cytokines by thiazolidinediones have an impact on the clearance of skin lesions. This study compares the efficacy and safety of pioglitazone versus methotrexate in moderate to severe psoriasis. Material and methods: We conducted a double-blind clinical trial comparing pioglitazone versus methotrexate in two groups of adult patients with psoriasis. Patients were scheduled every month for two months, we assessed the PASI (Psoriasis Area Severity Index) and took complete blood count, blood chemistry and liver profile every time. Statistical analysis was performed using Mann-Whitney U, Wilcoxon signed-rank test and χ² test. Results: We included a total of 9 patients, 4 in the pioglitazone group and 5 in the methotrexate group. The patients in the methotrexate group reduced their PASI score significantly after two months of treatment (p = 0.03), but not the pioglitazone group (p = 0.3) No adverse effects were reported in either group. Conclusion: Pioglitazone was not more effective than methotrexate in patients with moderate to severe psoriasis.

REFERENCES

1. Weigle N, McBane S. Psoriasis. Am Fam Physician. 2013; 87: 626-633.

2. Roenigk HH Jr, Auerbach R, Maibach H, Weinstein G, Lebwohl M. Methotrexate in psoriasis: Consensus conference. J Am Acad Dermatol. 1998; 38: 478-485.

3. Gelfand JM, Wan J, Callis Duffin K, Krueger GG, Kalb RE, Weisman JD et al. Comparative effectiveness of commonly used systemic treatments or phototherapy for moderate to severe plaque psoriasis in the clinical practice setting. Arch Dermatol. 2012; 148: 487-494.

4. Youssef J, Badr M. Role of peroxisome proliferator-activated receptors in inflammation control. J Biomed Biotechnol. 2004; 3: 156-166.

5. Robertshaw H, Friedmann PS. Pioglitazone: a promising therapy for psoriasis. Br J Dermatol. 2005; 152: 189-191.

6. Boyd AS. Thiazolidinediones in dermatology. Int J Dermatol. 2007; 46: 557-563.

7. Gutiérrez YZ. Evaluación del índice de severidad y área de la psoriasis (PASI) en 157 pacientes del club de psoriasis del Servicio de Dermatología del Hospital Nacional Daniel Alcides Carrión, año 2001. Dermatol Peruana. 2003; 13: 185-188.

8. Jeyaseelan L, Rao PS. Methods of determining sample sizes in clinical trials. Indian Pediatr. 1989; 26: 115-121.

9. Shafiq N, Malhotra S, Pandhi P, Gupta M, Kumar B, Sandhu K. Pilot trial: pioglitazone versus placebo in patients with plaque psoriasis (the P6). Int J Dermatol. 2005; 44: 328-333.

10. Pershadsingh HA, Sproul JA, Benjamin E, Finnegan J, Amin NM. Treatment of psoriasis with troglitazone therapy. Arch Dermatol. 1998; 134: 1304-1305.