Role of oral colchicine in plaque type psoriasis. A randomized clinical trial comparing with oral methotrexate

Background Patients with moderate to severe psoriasis generally require phototherapy,photochemotherapy or systemic agents to control their disease adequately. The potential toxic effects of long term use of the classic antipsoriatics, prolonged continuous therapy, higher cost and low socio-economic conditions of patients obligate us to consider some cheaper older alternatives like colchicine.Patients and methods A prospective, randomized controlled clinical trial was carried out on two groups of patient of psoriasis, group A (Case, n=30) was treated with 2.1 mg per day oral colchicine, in two divided doses and group B (Control, n= 30) was treated with 7.5 mg of oral methotrexate once weekly for 8 weeks. No topical agent except bland emollients was applied during the trial period. Psoriasis area severity index (PASI) was calculated as main outcome measure at entry level and follow up after one month and two months.Results The mean percentage reduction of PASI was statistically significant (£ =0.001) at both first and second follow up with oral colchicine. PASI-50 was achieved in 23.3% of respondent in colchicine group and 53.3% in methotrexate group (£ 0.05).Conclusion Oral colchicine is an effective therapy for chronic plaque psoriasis but it is less effective than methotrexate, the gold standard antipsoriatic therapy (£ 0.05)