Zeina Al Halasa

Background Methotrexate (MTX) is a cornerstone of systemic therapy for treating moderate to severe psoriasis. It can be given orally or subcutaneously (SC). SC MTX offers higher bioavailability and more predictable exposure. However, head-to-head clinical evidence is limited. We systematically compared the efficacy and safety of SC and oral MTX to inform route selection. Methods Building upon this background, we conducted a systematic review and network meta-analysis with random effects. Randomized controlled trials (RCTs) were identified from major databases up to 2025. Ten RCTs met the inclusion criteria. Outcomes included change in Psoriasis Area and Severity Index (PASI) from baseline, PASI 50/75/90/100 responses, and adverse events. Treatments were ranked using the Surface Under the Cumulative Ranking curve (SUCRA) probabilities. Results Our review and analysis showed that, across analyses, subcutaneous methotrexate (SC MTX) ranked higher than oral methotrexate (oral MTX) for PASI75 (SUCRA 0.98 vs. 0.52), PASI90 (0.98 vs. 0.39), and PASI100 (0.93 vs. 0.50). Subcutaneous methotrexate increased the odds of PASI75 (OR 5.48, 95% CI 2.53–11.85) and PASI90 (OR 3.33, 95% CI 1.09–10.13). Oral methotrexate slightly favored PASI50. Neither formulation reached significance for PASI100. Mean PASI reduction did not differ directly, despite superior rankings for subcutaneous methotrexate. Subcutaneous methotrexate was also associated with fewer adverse events and lower rates of discontinuation. Conclusion SC MTX more effectively achieves PASI thresholds and is better tolerated, supporting its use as the preferred systemic treatment for moderate to severe psoriasis.

Polycystic ovary syndrome (PCOS) is a common reproductive disorder that is related to a number of health issues and has an influence on a variety of metabolic processes. Despite its burden on the health of females, PCOS is significantly underdiagnosed, which is associated with lack of disease knowledge among females. Therefore, we aimed to gauge the awareness of PCOS in both the male and female population in Jordan. A descriptive cross-sectional study was conducted, targeting individuals over the age of 18 from Jordan’s central region. Participants were recruited through stratified random sampling. The questionnaire consisted of two domains, including demographics and knowledge of PCOS domains. A total of 1532 respondents participated in this study. The findings revealed that participants have overall adequate knowledge regarding PCOS’s risk factors, etiology, clinical presentation, and outcomes. However, participants demonstrated subpar familiarity of the association between PCOS and other comorbidities and the effect of genetics on PCOS. Women had more knowledge than men about PCOS (57.5 ± 6.06 vs. 54.1 ± 6.71, p = 0.019). In addition, older, employed, and higher-income populations showed significantly better knowledge than younger, unemployed, self-employed, and lower-income populations. In conclusion, we demonstrated that Jordanian women demonstrate an acceptable yet incomplete level of knowledge towards PCOS. We recommend establishing educational programs by specialists for the general population as well as medical personnel to spread accurate medical information and clarify common misconceptions about signs, symptoms, management, and treatment of PCOS, and nutritional knowledge.