Hadis Yousefzadeh, Farahzad Jabbari Azad, Mahnaz Banihashemi, Maryam Rastin, Mahmoud Mahmoudi
Journal: Acta dermatovenerologica Alpina, Pannonica, et Adriatica 2018;26(1):3-9
PMID: 28352928
Psoriasis Vulgaris is an immune-mediated chronic inflammatory disease that causes red, itchy, flaky, scaly skin. Methotrexate is an immune modulatory first-line conventional drug used to treat moderate psoriasis. Previous research suggests beneficial immune-modulatory and anti-inflammatory effects of micronutrient treatments. In this double-blinded trial, 30 Asian Psoriatic patients were randomly assigned either 7.5 to 15 mg of Methotrexate alone weekly or Methotrexate combined with daily micronutrient supplementation for 12 weeks. Patients in the micronutrient supplementation group received higher doses of micronutrients than the RDA and additional 5 mg folate supplementation on all days except the day of Methotrexate consumption. Inflammatory markers were significantly reduced by both treatments. Further, the combination of Methotrexate and micronutrient supplement resulted in greater immune modulation and decreased inflammation. For generalisation of the results, further robust research is needed. Using the results of this study, healthcare professionals can make effective therapeutic clinical decisions in the treatment of psoriasis by combining Methotrexate with micronutrient supplements.
INTRODUCTION
We evaluated the effectiveness of concomitant treatment with methotrexate (MTX) plus micronutrients in comparison with monotherapy with MTX only in psoriasis patients. Plasma levels of interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) were also measured and their association with clinical severity was evaluated.
METHODS
Thirty psoriasis patients 20 to 50 years old with a PASI score > 10 were divided randomly into two groups. Both groups were given oral methotrexate (0.2-0.3 mg/kg/week) for 12 weeks. In addition, Group B received one tablet of micronutrient supplement daily. Disease severity was calculated using the psoriasis area and severity index (PASI) score before and after 12 weeks. Levels of IL-1β and TNF-α were measured using enzyme-linked immunosorbent assay (ELISA).
RESULTS
We found that 13 (86.6%) patients in Group B and 8 (53.3%) patients in Group A attained a mild PASI score (≤ 10% body involvement). IL-1β and TNF-α levels were significantly decreased in favor of Group B (p < 0.05). There was a significant correlation between changes in both IL-1β and TNF-α levels and PASI score after the study (p < 0.05).
CONCLUSION
The results obtained were positive, and therefore double-blind randomized trials with a larger sample size are highly suggested to confirm or reject these results.
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