Summary.— The treatment of psoriasis with methotrexate carries a low but definite risk of producing histological abnormalities in the liver. Forty‐two patients treated for 3 to 80 months were found to have more histological abnormalities than 25 untreated patients with equally severe psoriasis. Of the treated patients, 3 had cirrhosis, all of whom were heavy drinkers, and 12 had fibrosis. None of the untreated patients had cirrhosis, but 4 had fibrosis. Only the cirrhotic patients showed clinical evidence of hepatic inpairment.
The incidence of histological abnormality increased with increasing cumulative dosage of methotrexate, but patients on weekly therapy had less abnormality than those on daily oral therapy.
Fourteen of the 25 untreated patients were given the drug subsequently, once weekly for a mean period of 23 months. Very few additional histological abnormalities have developed.
In patients with socially and physically crippling psoriasis where methotrexate would be used, the risk of significant hepatic damage is low enough to be acceptable, providing supervision is thorough.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.