Treating adult patients of severe psoriasis with methotrexate leads to reduction in biomarkers of atherosclerosis: A prospective study.

Background: Psoriasis is a common skin disorder; affecting 0.4-2% of general population and is associated with increased risk of cardiovascular diseases. We conducted this prospective study to determine change in biomarkers of atherosclerosis in plaque psoriasis in patients treated with methotrexate.

Methods: The study was carried out at a tertiary care centre over a period of 1 year after institutional ethical clearance. The study included 50 patients. Adults with severe psoriasis not receiving any systemic treatment for last 3 months were included in the study. Clinical parameters including psoriasis area and severity index (PASI), dermatology quality of life index (DLQI) and estimation of IL-6, hsCRP, and HDL levels and LDL: HDL ratio were done at baseline and at 12 weeks.

Results: A total of 50 patients were included and 42 completed the study. The mean age and mean duration of disease was 44.4 (±13.2) years and 10.8 (±9.9) years, respectively. Pre- and post-treatment mean PASI was 16.3 (±8.3) and 7.43 (±4.9), respectively ( = 0.001). The level of VEGF, IL-6, and hsCRP was 127 (±158) pg/ml, 5.3 (±2.5) pg/ml, and 4.2 (±4.1) mg/L, respectively. The levels of VEGF, IL-6, and hsCRP after 12 weeks of treatment were found to be 59.3 (±61) pg/ml (=0.006), 3.6 (±2.1) pg/ml ( < 0.001), and 2.6 (±3.1) mg/L ( = 0.012), respectively.

Conclusion: Methotrexate use in patients with chronic plaque psoriasis reduces the level of biomarkers of atherosclerosis at 12 weeks. Early treatment with methotrexate may help in reduction of cardiovascular risk in psoriasis patients.