Oxymatrine improves skin lesions, cuts Hepatitis B load

Erythrodermic psoriasis (EP) is a kind of psoriasis which is rare and severe, and whose management is challenging in patients with concomitant chronic hepatitis B (CHB). This randomized trial by Huijuan Shi et al. assessed the efficacy and safety of Oxymatrine (a natural alkaloid which comes from the Kushen root {Sophora flavescens}) as a treatment option for patients with EP, with particular emphasis on CHB.

The clinical trial comprised four consecutive patients with EP, including 2 patients A and B with concomitant hepatitis B. They all were administered Oxymatrine monotherapy intravenously for 8 weeks with a minimum follow-up of 24 weeks. The primary outcome was a minimum of 75% improvement in the psoriatic area and severity index (PASI75) score by the 32nd week. Improved Body Surface Area score (BSA), dermatology life quality index (DLQI) and safety were the secondary outcomes of the trial.

Post-treatment, patients A, B, and C achieved a PASI75 with an improvement of 77.4%, 97.2% and 100% in PASI respectively. Improvement in BSA and DLQI were also seen significantly at week 32 and throughout follow-ups of 37, 57, and 105 weeks (about 2 years), respectively. The viral loads significantly decreased in patients A and B. Patient D discontinued after 19 weeks. No adverse drug reactions were seen in any of the patients.

Thus, Oxymatrine proved an effective drug of choice for the treatment of patients with erythrodermic psoriasis including those with concomitant hepatitis B infections, as concluded.