A COMPREHENSIVE COMPARISON OF APREMILAST AND METHOTREXATE IN TREATING INTERFACE DERMATITIS: A RIGOROUS RANDOMIZED CONTROLLED STUDY

Abstract

Interface dermatitis, a complex skin condition affecting the delicate dermoepidermal junction, presents significant therapeutic complexities. This study meticulously compared the efficacy and tolerability of oral Apremilast and Methotrexate, two promising treatments for interface dermatitis.

Materials and Methods: This 12-week prospective randomized controlled study enrolled 36 patients specifically diagnosed with lichen planus, a form of interface dermatitis. Participants were divided into two groups: Group I received oral Apremilast (30mg twice daily), and Group II received oral Methotrexate (15mg weekly). Both groups were supplemented with emollients. Clinical responses were assessed using various scoring systems including Physician's Global Assessment (PGA), Visual Analog Scale (VAS), Lichen Planus Severity Index (LPSI), and mucosal scoring. Adverse effects and serious events were meticulously documented, and statistical analyses were conducted using appropriate methods.

Results: Both Apremilast and Methotrexate demonstrated significant reductions in key metrics throughout the study. Apremilast exhibited a 34.3% reduction in PGA, an 83.6% reduction in VAS, a 34% reduction in LPSI, and a 64.5% reduction in mucosal score. Methotrexate displayed a 46.8% reduction in PGA, an 85.4% reduction in VAS, a 29.5% reduction in LPSI, and a 65.4% reduction in mucosal score. Methotrexate showcased a slightly faster onset of relief, and fewer adverse events were observed in the Methotrexate group.

Conclusion: Both oral Apremilast and Methotrexate exhibit notable efficacy in treating interface dermatitis, with Methotrexate showing a marginally faster onset of relief and better tolerability. Apremilast, while generally well-tolerated, requires a careful titration strategy to manage gastrointestinal symptoms effectively. This study emphasizes the significance of personalized treatment approaches that balance therapeutic effectiveness and patient comfort when dealing with interface dermatitis