Effectiveness of methotrexate in moderate to severe psoriasis patients: real-world registry data from the Swiss Dermatology Network for Targeted Therapies (SDNTT)

  • Mathias Drach
  • Karolina Papageorgiou
  • Julia-Tatjana Maul
  • Vahid Djamei
  • Nikhil Yawalkar
  • Peter Häusermann
  • Florian Anzengruber
  • Alexander A. NavariniEmail author
Original Paper


Methotrexate (MTX) is a frequently used anti-psoriatic drug that is commonly recommended in international psoriasis guidelines. It is effective in treating skin lesions, nail changes and psoriatic arthritis. In 2017 a prospective, multicenter, randomized, double-blind, placebo-controlled, phase 3 trial, commonly known as the METOP trial, was published assessing the effectiveness and safety of subcutaneous administration of methotrexate. Because trial data do not always relate to real-life data with unselected patient populations, we wanted to determine whether the data obtained in the METOP-trial correspond to real-life registry data from our Swiss Dermatology Network for Targeted Therapies (SDNTT). Data of 449 patients with moderate to severe psoriasis who participated in the SDNTT registry between 2011 and 1st of July 2017 were analyzed. Only patients receiving methotrexate s.c. were included. 66 patients under MTX were included into this study. Baseline PASI was 6.3 ± 3.8 (SDNTT) compared to 15.9 ± 5.9 in the METOP trial. In our cohort, only 18% of all patients reached PASI 75 after 12 weeks, 6% showed a complete remission (PASI 100) compared to 41% and 4% in the METOP trial after 16 weeks. 22.7% of all patients showed increased liver enzymes in either study and nausea was seen in 15% (SDNTT) versus 22% (METOP) of patients. No severe adverse events were observed in our cohort. Compared to the METOP-trial, the response rates seen our real-world cohort were distinctly lower.


Methotrexate Psoriasis Folate acid METOP SDNTT MTX 


Compliance with ethical standards

Conflict of interest

Mathias Drach has no conflict of interest. Karolina Papageorgiou has no conflict of interest. Julia-Tatjana Maul is an employee of USZ and holds a “Filling the GAP” scholarship. Vahid Djamei has no conflict of interest. Nikhil Yawalkar has received honoraria for consulting and advisory board attendance from Abbvie, Almirall, Amgen, Celgene, Eli Lilly, Galderma, Gebro, Janssen, Leo, Novartis, MSD and Pfizer. Peter Häusermann has received honoraria for consulting and advisory board attendance from Abbvie, Almirall, Celgene, Eli Lilly, Galderma, Janssen, Leo and Novartis. Florian Anzengruber is an employee of the University Hospital Zurich. He has received honoraria from Abbvie, Celgene, Leo Pharma, Galderma, Eli Lilly, Almirall, Janssen—Cilag and Novartis, but has no financial interest, nor holds any shares of any pharmaceutical company. Alexander A. Navarini is on the advisory board of AbbVie, Pfizer, Novartis, Celgene, MSD, Galderma, Sanofi, Boehringer-Ingelheim, Lilly.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Mathias Drach
    • 1
    • 2
  • Karolina Papageorgiou
    • 1
    • 2
  • Julia-Tatjana Maul
    • 1
    • 2
  • Vahid Djamei
    • 1
    • 2
  • Nikhil Yawalkar
    • 3
  • Peter Häusermann
    • 4
  • Florian Anzengruber
    • 1
    • 2
  • Alexander A. Navarini
    • 4
    Email author
  1. 1.Department of DermatologyUniversity Hospital ZurichZurichSwitzerland
  2. 2.Department of ImmunologyUniversity Hospital ZurichZurichSwitzerland
  3. 3.Department of Dermatology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
  4. 4.Department of DermatologyUniversity Hospital BaselBaselSwitzerland

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