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Year : 1997  |  Volume : 63  |  Issue : 3  |  Page : 211

Evaluation of efficacy of therapy for psoriasis : methodological issues

Varanasi, India

Correspondence Address:
Sanjay Singh
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Source of Support: None, Conflict of Interest: None

PMID: 20944330

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How to cite this article:
Singh S, Pandey S S. Evaluation of efficacy of therapy for psoriasis : methodological issues. Indian J Dermatol Venereol Leprol 1997;63:211

How to cite this URL:
Singh S, Pandey S S. Evaluation of efficacy of therapy for psoriasis : methodological issues. Indian J Dermatol Venereol Leprol [serial online] 1997 [cited 2021 Jan 22];63:211. Available from:

To the Editor

We read with interest the recent article on the efficacy of sulfasalazine versus methotrexate in the treatment of psoriasis.[1] The authors have concluded that the efficacy of sulfasalazine was comparable to methotrexate, and established drug for treating severe psoriasis. However, a few methodological issues relating to the study need to be addressed.

In each treatment group 15 patients were included. This number does not appear to be adequate for evaluation of antipsoriatic property of a medication.[2] Inadequate number of patients are likely to show no difference between two treatments when a real difference exists. Further, the assessment of efficacy was made by grading erythema, scaling, and thickness of the lesions without taking into account different regions of the body and their extent of involvement. It would have been more appropriate if an accepted method of grading psoriasis, e.g. Psoriasis Area and Severity Index,[3] was used to enable us to arrive at meaningful conclusions. Further more, the patients in the methotrexate group received 7.5 mg of the drug per week. As the antipsoriatic dose of methotrexate is 0.2 to 0.4 mg per kg body weight per weak,[4] it appears that the patients received a suboptimal dose. It is highly likely that with an optimum dose the response would have been much better with methotrexate.

Though the authors have provided interesting preliminary findings, in view of the foregoing discussion, it appears that the achievement of the objective of the study[1] would require further work.

  References Top

1.Bharti R Girgla PS. Sulfasalazine in treatment of psoriasis, Ind J Dermatol Venereol Leprol 1996;62:87-88.  Back to cited text no. 1      
2.Singh S, Gopal J, Mishra RN, et al. Topical 0.05% betamethasone dipropionate: efficacy in psoriasis with once a day versus twice a day application, Br J Dermatol 1995;133:497-498.  Back to cited text no. 2      
3.Fredriksson T, Pettersson U. Severe psoriasis : oral therapy with a new retinoid, Dermatologica 1978;157:238-244.  Back to cited text no. 3      
4.Baker H. Psoriasis, In : Textbook of Dermatology Edited by Rook A, Wilkinson DS, Ebling FJG, et al, Blackwell, Oxford, 1986:1469-1532.  Back to cited text no. 4      


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