Intramuscular 50mg methotrexate injection therapy for severe psoriasis: Study on effectivity and side effect

Background Psoriasis is a chronic autoimmune and inflammatory skin disease. Parenteral methotrexate has promising potential to be used as treatment choice for severe psoriasis. However, no effectivity and safety data to be used severe psoriasis. Our objective is to determine the effectivity and safety of intramuscular 50 mg methotrexate for severe psoriasis. Methods This is a descriptive retrospective study in severe psoriasis. The data were taken from Dr. Sardjito Hospital Yogyakarta, Indonesia medical record, which fulfilled the inclusion and exclusion criteria. Subjects were previously administered with intramuscular 50 mg methotrexate injection according to the protocol. Comparative analysis is performed to determine treatment effectivity parameters consisting of psoriasis area severity index (PASI) and dermatological life quality index (DLQI) score. Side effects found in this study were analyzed descriptively. Results 35 severe psoriasis subjects were enrolled in this study. Significant PASI and DLQI scores reduction were found during treatment protocol. PASI-75 and PASI-90 scores were achieved by 50 subject in 4th and 8th week. Severe side effect of hepatotoxicity with >2 times SGOT/SGPT upper limit level elevation was found in 2.9 subjects. Conclusion Intramuscular 50 mg methotrexate injection can be an effective and safe treatment for severe psoriasis in a limited setting. © 2021 Pakistan Association of Dermatologists. All rights reserved.