Methotrexate versus Azathioprine in Chronic Plaque Type Psoriasis: A Comparative Study

Introduction: Psoriasis is chronic disease where treatments are often needed throughout life. Since 1806, when Thomas girdlestone used potassium arsenate for Psoriasis to present era, we are still in search of drug which can cure this disease. Azathioprine is a relatively safe drug which has not been tested vigourously for chronic plaque type Psoriasis. Aims and objectives: To evaluate and compare the effect of Methotrexate and Azathioprine in chronic plaque type Psoriasis. Material and methods: this study was a randomized, double blind control hospital based study, conducted over 100 Psoriasis patients, divided into two groups of 50 each. Group A which received Methotrexate in a dose of 15 mg weekly for 12 weeks. Group B received Azathioprine in a dose of 2 -3 mg/kg/day for 12 weeks. Severity of Psoriasis was assessed by PASI on 0,4,8 and 12 weeks and relapse was seen within 8 weeks of stopping the medication. Results: Statistically significant difference found after 8 and 12 weeks of treatment, with significantly higher PASI Clearnace by Methotrexate in comparison to Azathioprine. Conclusion: Although azthioprine is effective but Methotrexate is more effective than Azathioprine in chronic plaque type Psoriasis.