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Psoriasis Treatments Face Off

2 Popular Psoriasis Drugs Equally Effective but Have Different Side Effects

By Jennifer Warner
WebMD Health News

Reviewed by Michael W. Smith, MD

Aug. 13, 2003 -- Two common drugs used to treat moderate to severe psoriasis are likely to produce similar results in people who suffer from the skin disorder, according to a new study.

But researchers say although the psoriasis treatments, methotrexate and cyclosporine, are equally effective, each drug has specific side effects that should be taken into consideration.

Researchers say the study, published in the current issue of TheNew England Journal of Medicine, is the first head-to-head comparison of the drugs for psoriasis treatment.

Up to 7 million people in the U.S. suffer from psoriasis, which typically strikes people between the ages of 15 and 35. The disease causes scaling and inflammation of the skin and can vary in severity from small patches of irritation on the elbows, knees, and scalp to potentially disabling flare-ups that affect large portions of the body.

Various treatments for psoriasis are available, including topical creams and ointments, ultraviolet light therapy, and drugs that suppress the immune system, such as methotrexate and cyclosporine. For people with severe forms of the disease, frequently rotating psoriasis treatments is often recommended to reduce the risk of side effects, and cyclosporine is often the last line of defense.

Drugs Produce Similar Results

In the study, researchers compared the effectiveness of the two psoriasis treatments in 85 people with moderate to severe psoriasis for 16 weeks.

The study showed 94% of all patients had at least a 25% improvement in psoriasis severity and affected area after 12 weeks of psoriasis treatment.

The number of people who reached partial or complete remission was also similar between the two groups. Quality of life was also similar.

Side Effects Vary

The study showed that side effects did vary according to each psoriasis treatment.

Significantly more patients reported nausea with methotrexate than cyclosporine.
More patients on cyclosporine reported headaches, muscle aches, and numbness in the fingers than those on methotrexate.
One patient had to discontinue treatment with cyclosporine because of signs of liver damage.
Twelve patients had to discontinue methotrexate treatment because of elevations of liver enzymes.

Researcher Vera M.R. Heydendael, MD, of the University of Amsterdam, and colleagues say that both drugs were relatively well tolerated and the side effects were manageable.

Since the drugs were found to be equally effective, they say differences between the two psoriasis treatments in terms of side effects, ease of use (such as dosing regimens), and costs can be used to guide treatment decisions on an individual basis.

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