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Maha Fadel Mohamed Ali, Manal Salah, Maha Rafea, Nadia Saleh
Med Sci Monit 2008; 14(12): PI66-74
Because systemic treatment of psoriasis is associated with several adverse effects, methotrexate (MTX), either topically or as targeted delivery, has become a more-interesting alternative.
Material and Method: Methotrexate liposomes (LMTX) were prepared from DPPC, soy PC, egg yolk PC, and cholesterol. We studied the characterization, formulation of hydrogel (MTX 0.25%), and skin permeability, and compared LMTX gel with plain MTX gel and placebo for treating localized psoriasis in a double-blind study using albino mice. Gel formulations were applied daily, followed by irradiation with 80 joules from a 650-nm diode laser 3 times weekly for 12 weeks. Changes in disease signs and histopathological features were assessed.
Results: Drug release increased as laser energy increased following Higuchi's diffusion model and changed to zero order with energies > or = 80 J; significantly more MTX was released at all time intervals. Both LMTX and FMTX gels showed zero order kinetic release and antipsoriatic activity. During 8 months' follow-up, up to 60% of the patients treated with LMTX gel had no recurrence; this difference was statistically significant. No clinically significant changes were seen regarding blood or other laboratory variables.
Conclusions: Application of an 80-J diode laser to 0.25% LMTX hydrogel was beneficial for relieving psoriasis and did not exert systemic toxicity.