Local Methotrexate Injections for the Treatment of Nail Psoriasis

NCT ID: NCT06578728

Last Updated: 2025-09-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ENROLLING_BY_INVITATION

Clinical Phase

PHASE4

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-10

Study Completion Date

2026-01-31

Brief Summary

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The investigators hope to learn the efficacy of methotrexate injections for treatment of nail psoriasis.

Detailed Description

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Conditions

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Nail Psoriasis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Intra-subject randomized controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Patient blinded.

Study Groups

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Intralesional Methotrexate

Participants receive intralesional methotrexate injections into 1 nail bed/nail matrix every 6 weeks for 3 sessions.

Group Type EXPERIMENTAL

Methotrexate

Intervention Type DRUG

25mg/mL intralesional injection into nail bed/nail matrix

Intralesional Triamcinolone Acetonide

Participants receive intralesional triamcinolone acetonide injections into 1 nail bed/nail matrix every 6 weeks for 3 sessions.

Group Type ACTIVE_COMPARATOR

Triamcinolone Acetonide 10mg/mL

Intervention Type DRUG

10mg/mL intralesional injection into nail bed/nail matrix

Intralesional Placebo (saline)

Participants receive intralesional saline injections into 1 nail bed/nail matrix every 6 weeks for 3 sessions.

Group Type PLACEBO_COMPARATOR

Saline

Intervention Type DRUG

saline intralesional injection into nail bed/nail matrix

Interventions

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Methotrexate

25mg/mL intralesional injection into nail bed/nail matrix

Intervention Type DRUG

Triamcinolone Acetonide 10mg/mL

10mg/mL intralesional injection into nail bed/nail matrix

Intervention Type DRUG

Saline

saline intralesional injection into nail bed/nail matrix

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Subject must be at least 18 years of age
* Subject must have nail psoriasis that is clinically diagnosed in at least 3 fingernails

Exclusion Criteria

* Subject with any clinically significant condition or situation, other than the condition being studied that, in the opinion of the investigator, would interfere with study evaluations or optimal participation in the study. This is including, but not limited to: immunodeficiency, onychomycosis, any other nail condition other than psoriasis, allergy to methotrexate, triamcinolone acetonide, local anesthetic, normal saline, or any other material used for procedures
* Subject who has received radiation therapy, chemotherapy, and/or immunosuppressive drugs within 6 months of study, and/or oral corticosteroids or IV methotrexate for \>1 month within the 6 months of study (exception inhaled steroids);
* Subjects who use substances (medications, supplements, ect) known to significantly interact with drugs used as intervention in the study
* Subject who is pregnant, breastfeeding, or planning to get pregnant
* Subject known to have received treatment with investigational drugs or devices within 30 days prior to enrollment into this study
* Subject who is on systemic treatment for psoriasis
* Subject with baseline abnormalities in liver function tests or complete blood count
* Subjects with diagnosis of renal insufficiency or impairment
* Subject who is unwilling to abstain from any cosmetic nail treatments outside those provided by the study clinic, beyond basic nail trimming (i.e. no spa nail treatments, no nail polish use, no other topical prescription nail medication)
* Subject who is unwilling to abstain from any medical nail treatments on their nails other than the study intervention (i.e. topical steroids, antifungal creams) for the duration of the study intervention and for duration of the washout period (if applicable)
* Subject who is part of the staff personnel directly involved with this study or a family member of the investigational study staff
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Weill Medical College of Cornell University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Shari Lipner, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Weill Medical College of Cornell University

Locations

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Israel Englander Department of Dermatology

New York, New York, United States

Site Status

Countries

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United States

References

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Crowley JJ, Weinberg JM, Wu JJ, Robertson AD, Van Voorhees AS; National Psoriasis Foundation. Treatment of nail psoriasis: best practice recommendations from the Medical Board of the National Psoriasis Foundation. JAMA Dermatol. 2015 Jan;151(1):87-94. doi: 10.1001/jamadermatol.2014.2983.

Reference Type BACKGROUND
PMID: 25471223 (View on PubMed)

de Berker D. Management of nail psoriasis. Clin Exp Dermatol. 2000 Jul;25(5):357-62. doi: 10.1046/j.1365-2230.2000.00663.x.

Reference Type BACKGROUND
PMID: 11012585 (View on PubMed)

Baran R. [How to diagnose and treat psoriasis of the nails]. Presse Med. 2014 Nov;43(11):1251-9. doi: 10.1016/j.lpm.2014.06.011. Epub 2014 Oct 16. French.

Reference Type BACKGROUND
PMID: 25443636 (View on PubMed)

Edwards F, de Berker D. Nail psoriasis: clinical presentation and best practice recommendations. Drugs. 2009;69(17):2351-61. doi: 10.2165/11318180-000000000-00000.

Reference Type BACKGROUND
PMID: 19911853 (View on PubMed)

de Jong EM, Seegers BA, Gulinck MK, Boezeman JB, van de Kerkhof PC. Psoriasis of the nails associated with disability in a large number of patients: results of a recent interview with 1,728 patients. Dermatology. 1996;193(4):300-3. doi: 10.1159/000246274.

Reference Type BACKGROUND
PMID: 8993953 (View on PubMed)

Armstrong AW, Tuong W, Love TJ, Carneiro S, Grynszpan R, Lee SS, Kavanaugh A. Treatments for nail psoriasis: a systematic review by the GRAPPA Nail Psoriasis Work Group. J Rheumatol. 2014 Nov;41(11):2306-14. doi: 10.3899/jrheum.140881.

Reference Type BACKGROUND
PMID: 25362716 (View on PubMed)

Kivelevitch D, Frieder J, Watson I, Paek SY, Menter MA. Pharmacotherapeutic approaches for treating psoriasis in difficult-to-treat areas. Expert Opin Pharmacother. 2018 Apr;19(6):561-575. doi: 10.1080/14656566.2018.1448788. Epub 2018 Mar 22.

Reference Type BACKGROUND
PMID: 29565192 (View on PubMed)

Rigopoulos D, Baran R, Chiheb S, Daniel CR 3rd, Di Chiacchio N, Gregoriou S, Grover C, Haneke E, Iorizzo M, Pasch M, Piraccini BM, Rich P, Richert B, Rompoti N, Rubin AI, Singal A, Starace M, Tosti A, Triantafyllopoulou I, Zaiac M. Recommendations for the definition, evaluation, and treatment of nail psoriasis in adult patients with no or mild skin psoriasis: A dermatologist and nail expert group consensus. J Am Acad Dermatol. 2019 Jul;81(1):228-240. doi: 10.1016/j.jaad.2019.01.072. Epub 2019 Feb 5.

Reference Type BACKGROUND
PMID: 30731172 (View on PubMed)

Grover C, Daulatabad D, Singal A. Role of nail bed methotrexate injections in isolated nail psoriasis: conventional drug via an unconventional route. Clin Exp Dermatol. 2017 Jun;42(4):420-423. doi: 10.1111/ced.13087. Epub 2017 Apr 10.

Reference Type BACKGROUND
PMID: 28397295 (View on PubMed)

Jiaravuthisan MM, Sasseville D, Vender RB, Murphy F, Muhn CY. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. J Am Acad Dermatol. 2007 Jul;57(1):1-27. doi: 10.1016/j.jaad.2005.07.073.

Reference Type BACKGROUND
PMID: 17572277 (View on PubMed)

Wolf R, Tur E, Brenner S. Corticosteroid-induced 'disappearing digit'. J Am Acad Dermatol. 1990 Oct;23(4 Pt 1):755-6. doi: 10.1016/s0190-9622(08)81079-1. No abstract available.

Reference Type BACKGROUND
PMID: 2229508 (View on PubMed)

Requena L, Zamora E, Martin L. Acroatrophy secondary to long-standing applications of topical steroids. Arch Dermatol. 1990 Aug;126(8):1013-4. No abstract available.

Reference Type BACKGROUND
PMID: 2383026 (View on PubMed)

Deffer TA, Goette DK. Distal phalangeal atrophy secondary to topical steroid therapy. Arch Dermatol. 1987 May;123(5):571-2. No abstract available.

Reference Type BACKGROUND
PMID: 3579338 (View on PubMed)

Tosti A, Piraccini BM, Cameli N, Kokely F, Plozzer C, Cannata GE, Benelli C. Calcipotriol ointment in nail psoriasis: a controlled double-blind comparison with betamethasone dipropionate and salicylic acid. Br J Dermatol. 1998 Oct;139(4):655-9. doi: 10.1046/j.1365-2133.1998.02462.x.

Reference Type BACKGROUND
PMID: 9892909 (View on PubMed)

Other Identifiers

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23-09026516

Identifier Type: -

Identifier Source: org_study_id

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