Psoriasis
Conditions
Keywords
Psoriasis, Cardiovascular risk, Methotrexate, Vitamin D
Brief summary
The prevalence of cardiovascular risk in psoriasis has been reported in previous studies.Various studies have also shown that systemic treatments for psoriasis, including methotrexate, may significantly decrease this cardiovascular risk. We proposed that the addition of vitamin D may not only improve the therapeutic effect of various treatment modalities but also increase its effect on decreasing the cardiovascular risk in psoriasis. So our aim of work is to assess the Clinical improvement and cardiovascular risks in psoriatic patients after treatment with methotrexate alone with the dose of 0.2-0.5 mg/kg/week for three months in comparison to combined methotrexate with the same dose and vitamin D injection with the dose of 200,000 IU per month for 3 months. Each patient will do the following before starting treatment& after 3 months: 1. Fasting blood sugar, 2 hours postprandial and glycosylated hemoglobin 2. Liver and Kidney function tests. 3. Cardiovascular risk assessment by measuring the intima media thickness of carotid arteries using Carotid duplex and High sensitive C reactive protein measuring by particle-enhanced immunonephelometry on autoanalyzer. 4. Lipid profile (HDL, LDL, cholesterol and triglycerides). 5. Calculate body mass index and measure blood pressure 6. Albumin /creatinine ratio 7. Serum vitamin D level. Clinical response will be evaluated by Psoriasis Area and Severity index (PASI) & Psoriasis Disability Index (PDI) scores before and after 3 months of treatment
Interventions
DRUGMethotrexate
Methotrexate 2.5 mg tablet
DRUGVitamin D
Vitamin D 200,000 IU ampules
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
The patients will be randomly divided into 2 groups: Group A: 15 patients will take methotrexate weekly for 3 months for the treatment of psoriasis. Group B: will take methotrexate weekly in addition to Vitamin D injections monthly for 3 months for treatment of psoriasis
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Psoriasis patient not on systemic treatment at least for 3 months before inclusion in the study * PASI \>10
Exclusion criteria
* Patients with autoimmune diseases. * Patients with liver disease or kidney diseases * Patients with Diabetes mellitus * Females in child bearing period not using methods of contraception * Any associated dermatological disease * Evidence of infection * Pregnancy and lactation * Patients taking vitamin D
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Intima Media thickness of carotid arteries from baseline | Baseline and 12 weeks | Intima Media thickness of left and right common carotid arteries, bulb of common carotid arteries and internal carotid arteries as measured by carotid duplex before starting the treatment and after 3 months of treatment. |
| Change in high sensitive C- Reactive protein from baseline | Baseline and 12 weeks | Change in high sensitivity C-reactive protein (hsCRP), a soluble biomarker of systemic inflammation, after 3 months of treatment from baseline. |
| Psoriasis Area and Severity index change (PASI) | Baseline and 12 weeks | Change in PASI after 3 months of treatment from baseline |
Contacts
Primary ContactEman R Said, MD
Backup ContactMohamed HM El-Komy, MD
Outcome results
None listed