Premium
Methotrexate vs secukinumab safety in psoriasis patients with metabolic syndrome
Author(s) -
Gisondi Paolo,
Bellinato Francesco,
Bruni Manfredo,
De Angelis Giulia,
Girolomoni Giampiero
Publication year - 2020
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.14281
Subject(s) - medicine , secukinumab , methotrexate , psoriasis , metabolic syndrome , gastroenterology , creatinine , psoriasis area and severity index , body mass index , endocrinology , obesity , immunology , psoriatic arthritis
Abstract The safety of methotrexate in psoriasis patients with metabolic syndrome could be argued because of increased risk of liver toxicity. The aim of the study was to investigate the safety of methotrexate compared with secukinumab in psoriasis patients with metabolic syndrome. A controlled, open trial in psoriasis patients with metabolic syndrome, candidate to methotrexate, or secukinumab. Primary end point of the study was investigating any variations in waist circumference, body mass index, blood pressure, fasting glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglycerides, aspartate aminotransferase, alanine aminotransferase, creatinine levels between baseline and month‐6 and 12 of follow‐up in the two treatment cohorts. A total of 130 (110 male and 20 female) patients were consecutively assigned in a 1:1 ratio to treatment with methotrexate (n = 64) dosed 15 mg weekly or secukinumab (n = 66) at standard dose. At month‐6 and month‐12 serum levels of liver enzymes were significantly increased only in patients treated with methotrexate ( P < .01). Three times elevation of liver enzymes was reported in 4 of 64 patients receiving methotrexate, causing drug withdrawal. No significant changes in other parameters were observed. Methotrexate could induce a liver enzyme increase whereas secukinumab has a neutral effect.