Comparative Evaluation of the Effectiveness of Methotrexate and Apremilast in the Treatment of Chronic Plaque Psoriasis

Background: Psoriasis is a chronic inflammatory skin disorder associated with significant morbidity. Despite the availability of various treatments, including Methotrexate and Apremilast, a clear comparison of their effectiveness in treating chronic plaque psoriasis remains essential for optimizing patient outcomes. Aims & Objectives: This study aimed to evaluate and compare the therapeutic effects of Methotrexate and Apremilast in treating chronic plaque psoriasis, focusing on symptom improvement, PASI score reduction, and overall effectiveness. Methods: An analytical study was conducted over one year at the Dermatology OPD of Rajshree Medical Research Institute, Bareilly. Patients aged 18-50 years with chronic plaque psoriasis were divided into two groups: Group 1 received Methotrexate, and Group 2 received Apremilast. Psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI) at baseline and monthly intervals for six months. Data were analyzed using SPSS version 26.0, with statistical tests including paired t-tests, ANOVA, and chi-square tests. Results: The study found that Apremilast led to higher moderate improvement in scaling (70.4%) compared to Methotrexate (50%). By the PASI 6 stage, 92.5% of Apremilast patients achieved a PASI score below 15, compared to 76.92% of Methotrexate patients. Scalp involvement was more common in the Apremilast group (70.3%), while lower limb involvement was more prevalent in the Methotrexate group (42.3%). Conclusions: Both Methotrexate and Apremilast were effective in managing chronic plaque psoriasis, with Apremilast showing a quicker reduction in disease severity. The choice of treatment may depend on specific symptoms and patient characteristics.