Evaluation of Efficacy and Side Effects of Impairement Liver Function in Psoriasis Vulgaris Patients Treated with Methotrexate in Dr. Soetomo General Academic Hospital Surabaya: A Retrospective Study

Abstract

Background: Psoriasis is a chronic inflammatory skin disease that involves several factors, genetic, immunity defects, hormones, and environmental factors. Psoriasis vulgaris is often characterized by a thick, erythematous, well-defined, rough, layered, silvery white plaque. Methotrexate is a first-line systemic therapy in the management of psoriasis vulgaris. This drug effective to reduce the severity of the disease by at least 50% in more than 75% of patients. Unfortunately, methotrexate also has the potential to cause adverse effects, this drug is considered one of the main causes of increased liver enzymes in psoriasis patients for several years so special consideration is needed when prescribing methotrexate to patients. Therefore, periodic evaluation during the use of this drug is needed to find out the side effects that can be caused. Purpose: The aim was to to evaluate PASI, SGOT and SGPT score of psoriasis vulgaris patients who received methotrexate therapy at Dermatology and Venerology Outpatient and Inpatient Clinic Dr. Soetomo General Academic Hospital Surabaya. Methods: This was a observational analytical study with retrospective data through one shot case study pre-experimental study approach, but was conducted pre and post treatment that aimed to evaluate PASI, SGOT and SGPT score of psoriasis vulgaris patients who received methotrexate therapy at Dermatology and Venerology Outpatient and Inpatient Clinic Dr. Soetomo General Academic Hospital Surabaya for the period January 2018-December 2020. Results: The results of this study were 51 psoriasis patients who received methotrexate that include in inclusion criteria. The number of male patients was more than women, 30(58,8%) for men and 21(41.2%) for women. There was a statistically significant difference in the reduction in PASI score of psoriasis vulgaris patients before and after methotrexate therapy (p = 0.001). However, the results of statistical analysis SGOT score of psoriasis vulgaris patients before methotrexate therapy were no different than after receiving methotrexate therapy (p = 0.286). In contrast, the results of statistical analysis SGPT score of psoriasis vulgaris patients after receiving methotrexate therapy increased significantly compared to before receiving methotrexate therapy (p = 0.001). Conclusion: there was significant decrease in PASI scores and significant increase in SGPT scores before and after receiving methorexate therapy. However, for SGOT scores statistically there was no significant difference before and after receiving methorexate therapy.