{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:01:45Z","timestamp":1789189305861,"version":"build-2803163510"},"reference-count":18,"publisher":"Scientific Scholar","content-domain":{"domain":["ijdvl.com"],"crossmark-restriction":true},"short-container-title":["IJDVL"],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background:<\/jats:title>\n<jats:p>Palmoplantar psoriasis is a chronic debilitating condition which significantly impairs quality of life.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Objectives:<\/jats:title>\n<jats:p>To assess the efficacy and safety of the combination of apremilast and methotrexate compared with methotrexate monotherapy in the treatment of palmoplantar psoriasis. Also, to study the impact on treatment on the Dermatology Life Quality Index and Palmoplantar Quality of Life Index.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Methods:<\/jats:title>\n<jats:p>A total of 64 patients were randomised to two groups in a 1:1 ratio - Group A received both methotrexate and apremilast in combination, while Group B received only methotrexate, for 16 weeks. The primary endpoints were the mean score of Modified Palmoplantar Psoriasis Area and Severity Index at week 16, the proportion of patients achieving modified palmoplantar psoriasis area severity index-75 and\/or Palmoplantar Psoriasis Physician Global Assessment score 0\/1 at week 16.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Results:<\/jats:title>\n<jats:p>A significantly higher proportion of patients in Group A achieved Modified Palmoplantar Psoriasis Area and Severity Index-75 at week 16 (43% in Group A vs 30% in Group B). The Modified Palmoplantar Psoriasis Area and Severity Index score was significantly lower in the combination group at week 16 (4.03 \u00b1 2.05 in Group A and 5.89 \u00b1 2.31 in Group B, <jats:italic>P<\/jats:italic>-value = 0.002). About 80% of patients in the combination group with baseline Palmoplantar Psoriasis Physician Global Assessment \u22653 achieved Palmoplantar Psoriasis Physician Global Assessment 0\/1 compared to 60% in Group B. The combination group showed a significantly higher reduction in Dermatology Life Quality Index and Palmoplantar Quality of Life Index scores compared to the methotrexate alone group (<jats:italic>P<\/jats:italic>-value = 0.025). No notable adverse events were observed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st5\">\n<jats:title>Limitation:<\/jats:title>\n<jats:p>The limitations of the study were single blinding, small sample size and a lack of longer follow up to assess the rate of relapse. We did not account for attrition during sample size calculation. Also, due to the paucity of data regarding the use of apremilast in palmoplantar psoriasis, definitive comparisons could not be made with previous studies.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st6\">\n<jats:title>Conclusion:<\/jats:title>\n<jats:p>The combination of apremilast and methotrexate has superior efficacy and a similar safety profile as compared to methotrexate monotherapy for the treatment of moderate to severe palmoplantar psoriasis.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/ijdvl_843_2021","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T08:12:16Z","timestamp":1654848736000},"page":"213-220","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Methotrexate monotherapy versus methotrexate and apremilast combination therapy in the treatment of palmoplantar psoriasis: A prospective, randomised, assessor-blinded, comparative study"],"prefix":"10.25259","volume":"89","author":[{"given":"Trashita","family":"Hassanandani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maitreyee","family":"Panda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajaya Kumar","family":"Jena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinmoy","family":"Raj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"10.25259\/IJDVL_843_2021\/ref-1","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1111\/j.1468-3083.2009.03197.x","article-title":"A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patients","volume":"23","author":"Adisen","year":"2009","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.25259\/IJDVL_843_2021\/ref-2","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1111\/j.1529-8019.2010.01361.x","article-title":"Therapeutic hotline. Alefacept in the treatment of hyperkeratotic palmoplantar psoriasis","volume":"23","author":"Lior","year":"2010","journal-title":"Dermatol Ther"},{"key":"10.25259\/IJDVL_843_2021\/ref-3","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.jaad.2016.07.058","article-title":"Secukinumab shows significant efficacy in palmoplantar Methotrexate and apremilast in palmoplantar psoriasis psoriasis: Results from GESTURE, a randomized controlled trial","volume":"76","author":"Gottlieb","year":"2017","journal-title":"J Am Acad Dermatol"},{"key":"10.25259\/IJDVL_843_2021\/ref-4","doi-asserted-by":"publisher","first-page":"1402","DOI":"10.1111\/j.1468-3083.2011.03984.x","article-title":"Treatment of palmoplantar psoriasis with infliximab: A randomized, double-blind placebo-controlled study","volume":"25","author":"Bissonnette","year":"2011","journal-title":"J Eur Acad Dermatol"},{"key":"10.25259\/IJDVL_843_2021\/ref-5","doi-asserted-by":"publisher","first-page":"e246","DOI":"10.1111\/jdv.15518","article-title":"Low dose acitretin versus methotrexate in the treatment of palmoplantar psoriasis: A case series","volume":"33","author":"Gisondi","year":"2019","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.25259\/IJDVL_843_2021\/ref-6","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.jaad.2016.02.1164","article-title":"Apremilast, an oral phosphodiesterase-4 inhibitor, in the treatment of palmoplantar psoriasis: Results of a pooled analysis from phase II PSOR-005 and phase III Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis (ESTEEM) clinical trials in patients with moderate to severe psoriasis","volume":"75","author":"Bissonnette","year":"2016","journal-title":"J Am Acad Dermatol"},{"key":"10.25259\/IJDVL_843_2021\/ref-7","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1016\/j.ad.2018.12.002","article-title":"Incremental cost per responder (PASI-75, PASI-90 and PASI-100) based on a network meta-analysis of biologic therapies for psoriasis: Spain 2018","volume":"110","author":"Puig","year":"2019","journal-title":"Actas Dermosifiliogr"},{"key":"10.25259\/IJDVL_843_2021\/ref-8","doi-asserted-by":"publisher","first-page":"1724","DOI":"10.3899\/jrheum.151376","article-title":"A phase III, randomized, controlled trial of apremilast in patients with psoriatic arthritis: Results of the PALACE 2 trial","volume":"43","author":"Cutolo","year":"2016","journal-title":"J Rheumatol"},{"key":"10.25259\/IJDVL_843_2021\/ref-9","doi-asserted-by":"publisher","first-page":"e384","DOI":"10.1111\/jdv.12004","article-title":"Efficacy and safety of systemic methotrexate vs. acitretin in psoriasis patients with significant palmoplantar involvement: A prospective, randomized study","volume":"27","author":"Janagond","year":"2013","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.25259\/IJDVL_843_2021\/ref-10","first-page":"362","article-title":"Combination topical PUVAsol with methotrexate versus methotrexate in the treatment of palmoplantar psoriasis","volume":"14","author":"Karn","year":"2016","journal-title":"Kathmandu Univ Med J"},{"key":"10.25259\/IJDVL_843_2021\/ref-11","doi-asserted-by":"publisher","first-page":"165","DOI":"10.4103\/0019-5154.80410","article-title":"Comparative therapeutic evaluation of different topicals and narrow band ultraviolet B therapy combined with systemic methotrexate in the treatment of palmoplantar psoriasis","volume":"56","author":"Gupta","year":"2011","journal-title":"Indian J Dermatol"},{"key":"10.25259\/IJDVL_843_2021\/ref-12","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1002\/cpdd.109","article-title":"The pharmacokinetic effect of coadministration of apremilast and methotrexate in individuals with rheumatoid arthritis and psoriatic arthritis","volume":"3","author":"Liu","year":"2014","journal-title":"Clin Pharmacol Drug Dev"},{"key":"10.25259\/IJDVL_843_2021\/ref-13","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1016\/j.jaad.2008.11.910","article-title":"Palmoplantar psoriasis: A phenotypical and clinical review with introduction of a new quality-of-life assessment tool","volume":"60","author":"Farley","year":"2009","journal-title":"J Am Acad Dermatol"},{"key":"10.25259\/IJDVL_843_2021\/ref-14","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1111\/jdv.14647","article-title":"Apremilast for the treatment of moderate-to-severe palmoplantar psoriasis: Results from a double-blind, placebo-controlled, randomized study","volume":"32","author":"Bissonnette","year":"2018","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.25259\/IJDVL_843_2021\/ref-15","doi-asserted-by":"publisher","first-page":"543944","DOI":"10.3389\/fmed.2020.543944","article-title":"Successful treatment of refractory palmoplantar pustular psoriasis with apremilast: A case series","volume":"7","author":"St\u00e4nder","year":"2020","journal-title":"Front Med"},{"key":"10.25259\/IJDVL_843_2021\/ref-16","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1177\/1203475416631328","article-title":"Use of apremilast in combination with other therapies for treatment of chronic plaque psoriasis","volume":"20","author":"AbuHilal","year":"2016","journal-title":"J Cutan Med Surg"},{"key":"10.25259\/IJDVL_843_2021\/ref-17","doi-asserted-by":"publisher","first-page":"3076","DOI":"10.1210\/en.2009-0108","article-title":"Reduced adiposity and high-fat diet-induced adipose inflammation in mice deficient for phosphodiesterase 4B","volume":"150","author":"Zhang","year":"2009","journal-title":"Endocrinology"},{"key":"10.25259\/IJDVL_843_2021\/ref-18","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1006\/bbrc.2001.6259","article-title":"Cyclic AMP-specific phosphodiesterase 4 inhibitors promote ABCA1 expression and cholesterol efflux","volume":"290","author":"Lin","year":"2002","journal-title":"Biochem Biophys Res Commun"}],"container-title":["Indian Journal of Dermatology, Venereology and Leprology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ijdvl.com\/methotrexate-monotherapy-versus-methotrexate-and-apremilast-combination-therapy-in-the-treatment-of-palmoplantar-psoriasis-a-prospective-randomised-assessor-blinded-comparative-study\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ijdvl.com\/methotrexate-monotherapy-versus-methotrexate-and-apremilast-combination-therapy-in-the-treatment-of-palmoplantar-psoriasis-a-prospective-randomised-assessor-blinded-comparative-study\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T11:29:37Z","timestamp":1679570977000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ijdvl.com\/methotrexate-monotherapy-versus-methotrexate-and-apremilast-combination-therapy-in-the-treatment-of-palmoplantar-psoriasis-a-prospective-randomised-assessor-blinded-comparative-study\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,30]]},"references-count":18,"alternative-id":["10.25259\/IJDVL_843_2021"],"URL":"https:\/\/doi.org\/10.25259\/ijdvl_843_2021","relation":{},"ISSN":["0973-3922","0378-6323"],"issn-type":[{"value":"0973-3922","type":"electronic"},{"value":"0378-6323","type":"print"}],"subject":[],"published":{"date-parts":[[2022,6,30]]},"article-number":"213"}}