ArticleCureus2025
Evaluation of the Therapeutic and Economic Impact of Adalimumab Versus Methotrexate in the Management of Psoriasis: A Prospective Comparative Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
backgroundPsoriasis is a chronic inflammatory skin disease often requiring systemic therapy for moderate-to-severe cases. Methotrexate (MTX) is a cost-effective conventional treatment, while adalimumab (ADL), a tumor necrosis factor-alpha (TNF-α) inhibitor, offers higher efficacy but at a significantly higher cost. Comparative real-world data on their effectiveness, safety, and cost-efficiency in resource-limited settings remain scarce.
aimIn the present study, we aimed to compare the therapeutic efficacy, safety profile, and cost-effectiveness of ADL versus MTX in the treatment of moderate-to-severe plaque psoriasis.
methodsThis prospective, observational study was conducted with 80 (100%) adult patients, divided equally into the ADL group (n=40, 50%) and the MTX group (n=40, 50%). Patients were evaluated over 24 weeks for clinical efficacy (Psoriasis Area Severity Index (PASI) 75/90 response rates), safety (adverse drug reactions (ADRs)), quality of life (Dermatology Life Quality Index (DLQI) scores), and pharmacoeconomic parameters, including average cost-effectiveness ratio (ACER) and incremental cost-effectiveness ratio (ICER).
resultsAt week 24, PASI 75 and PASI 90 responses were significantly higher in the ADL group (n=25, 62.16% and n=11, 27% respectively) compared to the MTX group (n=10, 23.7% and n=1, 2.63% respectively) (p<0.05). ADL showed greater mean PASI reduction (8.95 vs. 6.58; p<0.001) and DLQI improvement (8.22 vs. 4.89; p<0.001). Adverse events were similar between groups. However, ADL incurred a markedly higher treatment cost (₹97,500 vs. ₹396.4). The ACER per PASI 75 responder was ₹156,784.42 for ADL versus ₹1,672.15 for MTX. ICER for an additional PASI 75 responder with ADL was ₹252,553.97.
conclusionsADL demonstrated superior clinical efficacy and quality-of-life improvement over MTX but at a substantially higher cost. Despite its effectiveness, ADL's economic burden limits its feasibility in resource-constrained settings. MTX remains the more cost-effective option, underscoring the need for affordability-enhancing measures for biologics in India.
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