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. 2021 Apr 19;2021(4):CD011535. doi: 10.1002/14651858.CD011535.pub4

Hunter 1963.

Study characteristics
Methods RCT, placebo‐controlled, double‐blind trial
Date of study: not stated
Location: 1 centre in London, UK
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 (pp 1 and 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 (pp 1 and 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