Nghiên cứu hiệu quả điều trị, tính an toàn và khả năng dung nạp của methotrexate trong điều trị viêm khớp vảy nến

Abstract

Objective: To access the effectiveness, safety and tolerance of methotrexate in psoriatic arthritis treatment. Subject and method: Prospective study, clinical trial and convenient sampling on 37 patients admitted at Ho Chi Minh City Hospital of Dermato-Venereology from January 2016 to March 2017, with methotrexate dosage ranging from 10mg to 15mg per week. Result and conclusion: Patients’ characteristics: Female/male ratio was 2/1, the mean age of onset was 48 (13). Nearly 3/4 cases had psoriasis on skin as the first sign. Peripheral arthritis had high percentage (81.08%). Joint deformity rate was 37%. The arthritis existed about 0.83 (0.08 - 2.91) years on median. HLA B27 and DR7 were similarly positive, accounting for 32.43%, with only one HLA Cw06 positive (2.7%). Arthritis activity was medium (59.38%), and severe (25%). Erythrocyte sediment rate (ESR) was high, 50 (14 - 158) mm/hour on average. Treatment with methotrexate improved arthritis activity significantly after 12 weeks (DAS28 was 4.3 ± 1 before treatment and 3.0 ± 1.0 at week 12). At week 12, the rate of recovery according to DAS28-EURLA criteria was 37.84%. PASI50 score was more than 50% at week 12. There was nothing wrong with clinical characteristics and complete blood count. One patient had high liver enzyme SGPT but no clinical appearance, and stopped treatment.