Sridhar, V (2015) Comparative Study on Efficacy, Safety and Tolerability of Oral Methotrexateand Oral Azathioprine in Chronic Plaque Psoriasis. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION: Psoriasis is a common, chronic, and recurrent inflammatory disease of the skin. It has a tendency to wax and wane with flares related to systemic or environmental factors including life stress events and infection. Psoriasis is characterised by the infiltration of skin by activated T cells and an abnormal proliferation of keratinocytes. A classic lesion of psoriasis is characterised by well demarcated, raised, red plaques of varying sizes with a white scaly surface. Psoriasis also shows its impact on quality of life and potentially long term survival. Methotrexate: Methotrexate has a greater affinity for dihydrofolic acid reductase than has folic acid. The synthesis of DNA is blocked when dihydrofolic acid reductase is bound and thereby cell division is reduced. Methotrexate may also affect the inflammatory element of psoriasis. Azathioprine: Azathioprine is an immunosuppressive drug which is converted non-enzymatically in the body to 6-mercaptopurine (6-MP), then by hypoxanthine guanine phosphoribosyl transferase (HGPRT) to 6-thioguanine nucleotides. Their immunosuppressive activity results from disruption of normal DNA and RNA synthesis. Additionally, an imidazole metabolite appears to have powerful anti-inflammatory properties. OBJECTIVES: To assess the efficacy, safety and tolerability of T. methotrexate 15mg/wk and T.azathioprine 50mg/day in chronic plaque psoriasis. METHODS AND MATEIALS: PLACE OF STUDY : Govt. Stanley Medical College, Chennai. TYPE OF STUDY : Randomised, Prospective, Open Label, Parallel Group Study. TIME DURATION : One year.(June 2013 to May 2014). SAMPLE SIZE : 2 groups, each containing 20 patients. STUDY PROCEDURE: A brief and relevant medical history with physical examination will be taken at screening visit to ensure all the relevant eligibility criteria are met. After successful screening, patient would be randomised to one of the two treatment groups as follows, GROUP A: Patients who fulfil inclusion criteria and willing to take part in trial and sign consent letter would be included in the study. They would be administered T.METHOTREXATE 15mg/week for 12 weeks. Efficacy will be assessed by monitoring PASI score every week. Safety and tolerability monitored by complete hemogram weekly and liver function test biweekly. GROUP B: Patients who fulfil inclusion criteria and willing to take part in trial and sign consent letter would be included in the study. They would be administered T.AZATHIOPRINE 50mg/day for 12 weeks. Efficacy will be assessed by monitoring PASI score every week. Safety and tolerability monitored by complete hemogram weekly and liver function test biweekly. CONCLUSION: Methrotrexate was found to be more efficacious than azathioprine in achieving PASI 75 at week 12. Both the drugs were safer and tolerable while remission period in the Methotrexate group was longer than Azathioprine group.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Psoriasis ; Methotrexate ; Azathioprine. |
| Subjects: | MEDICAL > Dermatology Venereology and Leprosy |
| Depositing User: | Punitha K |
| Date Deposited: | 05 May 2018 08:40 |
| Last Modified: | 05 May 2018 08:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7483 |
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