Introduction: Psoriasis chronic inflammatory skin disorder typically characterized by erythematous papules and plaques. Methotrexate acts by inhibiting dihydrofolic reductase enzyme and apremilast is an oral phosphodiesterase-4 inhibitor, which are effective in the management of moderate to severe psoriasis. The current study was aimed to evaluate the effectiveness of methotrexate and apremilast in treating moderate to severe plaque psoriasis. Material and methods: A total of 52 participants of both genders with moderate to severe plaque psoriasis attending outpatient department aged between 18 to 60 years were included. Participants were randomly divided in to group 1 (n=26) medicated with 7.5 mg Methotrexate per week and group 2 (n=26) medicated with Apremilast with a started dose of 10 mg and titrated to a maximum dose of 30 mg two time in a day. The participants were assessed for treatment response and adverse effects for a period of 4 months. The severity of psoriasis was assessed by psoriasis are severity index (PASI). Results: The mean age of onset was 36.7 years in group 1 and 35.28 years in group 2. 73.1% were suffering with 2 years. SCALP was commonly affected part (80.8% each), followed by nails (61.5% & 57.7%), palm and sole (26.9% & 30.76%). 84.61% and 80.76% patients were achieved PASI75 in group 1 and 2 respectively. Headache is common adverse event followed by nausea, vomiting and lower abdomen pain. 3.84% of patients. Conclusion: Methotrexate and Apremilast did not show significant difference in achieving PASI75 at the end of 4th month of treatment and are equally efficacious in the management of moderate to severe grade psoriasis.

Introduction: Psoriasis chronic inflammatory skin disorder typically characterized by erythematous papules and plaques. Methotrexate acts by inhibiting dihydrofolic reductase enzyme and apremilast is an oral phosphodiesterase-4 inhibitor, which are effective in the management of moderate to severe psoriasis. The current study was aimed to evaluate the effectiveness of methotrexate and apremilast in treating moderate to severe plaque psoriasis. Material and methods: A total of 52 participants of both genders with moderate to severe plaque psoriasis attending outpatient department aged between 18 to 60 years were included. Participants were randomly divided in to group 1 (n=26) medicated with 7.5 mg Methotrexate per week and group 2 (n=26) medicated with Apremilast with a started dose of 10 mg and titrated to a maximum dose of 30 mg two time in a day. The participants were assessed for treatment response and adverse effects for a period of 4 months. The severity of psoriasis was assessed by psoriasis are severity index (PASI). Results: The mean age of onset was 36.7 years in group 1 and 35.28 years in group 2. 73.1% were suffering with 2 years. SCALP was commonly affected part (80.8% each), followed by nails (61.5% & 57.7%), palm and sole (26.9% & 30.76%). 84.61% and 80.76% patients were achieved PASI75 in group 1 and 2 respectively. Headache is common adverse event followed by nausea, vomiting and lower abdomen pain. 3.84% of patients. Conclusion: Methotrexate and Apremilast did not show significant difference in achieving PASI75 at the end of 4th month of treatment and are equally efficacious in the management of moderate to severe grade psoriasis.