Azathioprine Pulse Therapy in the treatment of psoriatic arthritis: A case series

Abstract

Background/objectiveTreatment available for treating psoriasis of joint are able to clear the lesions but relapse is common. While treating psoriasis with Azathioprine Pulse Therapy, it was observed that the involvement of joints (arthritis of small and big joints) also cleared. To see whether intermittent high dose (IHD) and continuous low dose (CLD) azathioprine given to clear psoriasis also clear the joint involvements and produce prolong/permanent remission. MethodsSix out of 60 psoriasis patients treated with azathioprine pulse therapy (APT) had joints involvement. All received azathioprine pulse therapy for treating psoriasis which contain azathioprine 500 mg given on three consecutive days and was repeated every month on the same date along with azathioprine100 mg orally in between the IHD. The entire treatment was divided into four phases. Phase I, continued till clearance of all lesions of psoriasis. In phase II nine more APT is given. In phase III only azathioprine100 mg was continued for 9 months. In phase IV azathioprine100 mg was also stop and patients were followed up without any treatment for any recurrence till the end of the study. ResultSix patients with joint pain and arthritis cleared in 1–12 months and are in remission since 35–95 months. ConclusionsThus azathioprine pulse therapy regimen is able to put psoriatic arthritis into prolong/permanent remission.