Comparative efficacy of hydroxyurea and methotrexate in treating psoriasis

A clinical trial study in the treatment of psoriasis was conducted in twenty three patients. The patients of psoriasis attending at the department of Dermatology and Venereology, BSMMU, Dhaka during the period of July 2009 to May 2010 were enrolled in this study. Eleven patients were treated with oral hydroxyurea (case), belonged to Group A and rest 13 patients were treated with oral methotrexate (control), belonged to Group B. Elements of the Psoriasis Area and Severity Index (PASI) were calculated as main outcome measure at baseline; follow up after 4 weeks and finally at 8 weeks. The mean PASI score for the Group A patients was 17.0±7 and that of Group B patients was 13.8±3. The mean reduction was higher among the Group B patients (11.8±3.5) than the Group A patients (13.5±6.8), but the mean reduction was not statistically significant (p>0.05) between two groups of patients. The mean percentage of decrease of PASI score was found to be high among the Group B patients (84.9±10.4, i.e. 85%) than the Group A patients (77.6±14.0, i.e. 78%), but the mean difference was not statistically significant (p>0.05). Analysis revealed that a statistically significant improvement of psoriasis was observed based on PASI score eight weeks of treatment in both treatment group (p=0.001). There was no statistically significant mean difference was found between Group A and Group B patients in terms of blood hemoglobin, erythrocyte sedimentation rate, WBC and platelet count and serum ALT (p>0.05). The current study showed adverse effects in 7(63%) patients of Group A and 8(66.6%) patients of Group B. In both groups of patients the adverse effects were few and mild in nature. So hydroxyurea can be alternative drug to methotrexate in the treatment of psoriasis.