• Psoriasis is a chronic disease that requires long-term treatment to control symptoms
• In moderate-to-severe psoriasis, patients are treated with conventional systemic disease-modifying antirheumatic drugs (csDMARDs), such as methotrexate (MTX) and ciclosporin A (CSA), and systemic retinoids such as acitretin (ACI)
• While biologic systemic disease-modifying antirheumatic drugs (bsDMARDs) are available, they are significantly more expensive and are generally reserved for patients failing csDMARDs
• A subcutaneous formulation of MTX (SC-MTX, Metoject®) has been licensed for psoriasis, providing an additional treatment option for patients prior to biologic therapy
• A recent trial investigating the efficacy of SC-MTX vs placebo in psoriasis demonstrated potential differences in efficacy of SC-MTX compared to trails with oral methotrexate (O-MTX)
• The use of SC-MTX in rheumatoid arthritis has also shown key differences between SC-MTX and O-MTX, notably in the context of drug survival
• With increased pressure on the National Health Service (NHS) in the United Kingdom (UK), it is important to investigate the potential for cost savings, especially for chronic diseases associated with high long-term costs

Authors: Bungey G, Webb N, Price K, O’Leary M

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