Hunter 1963

Methods	RCT, placebo‐controlled, double‐blind trial Date of study: not stated Location: 1 centre in London
Participants	Randomised: 41 participants (no description of the study population) Inclusion criteria Participants with moderate‐severe psoriasis Exclusion criteria Not stated Dropouts and withdrawals included (41) analysed (36)
Interventions	Intervention A. Methotrexate (n = 19), orally, 2.5 mg every day for 1 week and 1 week after Control intervention B. Placebo (n = 17), orally, every day for 1 week and 1 week after
Outcomes	Assessments not clearly stated (reported at 4 weeks) Primary outcomes of the trial Not stated Outcomes of the trial Scale: 0 = no improvement 1 = definite improvement 2 = marked improvement 3 = complete clearing
Notes	Funding: not stated Declarations of interest: not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Comment: no description of the method used to guarantee random sequence generation
Allocation concealment (selection bias)	Unclear risk	Comment: no description of the method used to guarantee random sequence generation
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Quote (p 1 & 2): “Control tablet of identical appearance... thus neither physician, patient nor pharmacist was aware whether drug or control had been dispensed” Comment: probably done
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote (p 1 & 2): “Control tablet of identical appearance... thus neither physician, patient nor pharmacist was aware whether drug or control had been dispensed” Comment: probably done
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	41 randomised participants and 38 analysed Comment: no description of the method used to manage missing data Not ITT analyses
Selective reporting (reporting bias)	High risk	No pre‐specified outcomes mentioned in the methods section