Efficacy and Safety of Oxymatrine in the Treatment of Patients with Erythrodermic Psoriasis.

Abstract

The management of erythrodermic psoriasis (EP), a rare but severe type of psoriasis, is challenging, especially in patients with concomitant chronic hepatitisB (CHB). We previously demonstrated that oxymatrine treatment alleviated severe plaque psoriasis, but its therapeutic potential in treating EP remains unexplored. This study was to assess the efficacy and safety of oxymatrine for the treatment of EP, with attention to concomitant CHB. In this investigator-initiated clinical trial, four consecutive patients with EP, including two (A and B) with concomitant CHB, were treated with intravenous administration of oxymatrine as monotherapy for 8weeks, and scheduled to be followed up for a minimum of 24weeks. The primary outcome was at least 75% improvement in the psoriasis area and severity index (PASI75) at week32. Secondary outcomes included the body surface area (BSA) score, dermatology life quality index (DLQI)], and safety. Patients A, B, and C achieved PASI75 at treatment completion and week32, demonstrating improvements of 77.4%, 97.2%, and 100% in PASI, respectively. Their BSA and DLQI were also improved significantly at week32 and throughout follow-up of 37, 57, and 105weeks, respectively. The viral loads in patientsA and B with CHB decreased modestly. PatientD discontinued after follow-up for 19weeks, and the primary outcome could not be analyzed. No adverse events were reported during treatment and follow-up. Oxymatrine appears to be efficacious and safe for the treatment of patients with EP, including those with concomitant CHB. This study was registered at the Chinese Clinical Trial Registry ( www.chictr.org.cn ; Registration number ChiCTR-TRC-14004301).