The impact of methotrexate therapy with vitamin D supplementation on the cardiovascular risk factors among patients with psoriasis; a prospective randomized comparative study

J Dermatolog Treat. 2022 May;33(3):1617-1622. doi: 10.1080/09546634.2021.1871581. Epub 2021 Jan 25.


Background: Controlling psoriasis with various systemic treatments, including methotrexate, may significantly decrease associated cardiovascular risk problems.

Objective: To assess the value of vitamin D supplementation on clinical response as well as changes in cardiovascular risk parameters in psoriasis patients treated with methotrexate.

Methods: This prospective randomized comparative study included 30 patients with moderate to severe psoriasis divided randomly to receive either methotrexate alone (Mtx) or methotrexate plus intramuscular vitamin D (MtxD) for 3 months. Lipid profile, HsCRP, carotid intima-media thickness (CIMT) and blood pressure (BP) measurements were recorded before and after the therapy.

Results: At end of study period, significant clinical improvement in both groups was observed. CIMT and systolic BP decreased in both groups but only statistically significant in Mtx group. HsCRP decreased in both groups but didn't reach statistical significance. We also observed, an increase in triglycerides and cholesterol levels in the Mtx group with the latter decreasing in the combined Mtx and vitamin D therapy group.

Conclusion: Treating psoriasis with methotrexate may decrease cardiovascular disease risk factors. Adding vitamin D supplementation to methotrexate may protect lipid homeostasis, specifically cholesterol and triglycerides.

Keywords: Cardiovascular risk; methotrexate; psoriasis; vitamin D.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • C-Reactive Protein
  • Cardiovascular Diseases* / etiology
  • Cardiovascular Diseases* / prevention & control
  • Carotid Intima-Media Thickness
  • Cholesterol / blood
  • Dietary Supplements
  • Heart Disease Risk Factors
  • Humans
  • Lipids
  • Methotrexate* / therapeutic use
  • Prospective Studies
  • Psoriasis* / complications
  • Psoriasis* / drug therapy
  • Triglycerides / blood
  • Vitamin D* / therapeutic use


  • Lipids
  • Triglycerides
  • Vitamin D
  • C-Reactive Protein
  • Cholesterol
  • Methotrexate