Effects of acitretin on the liver

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

“…22,90 Severe hepatotoxic reactions resulting from retinoid use are rare, and reports include a severe cholestatic hepatitis occurring in a patient with a hypoplastic kidney, 11,96 and a severe hepatotoxic reaction with progression to liver cirrhosis. 90,97,98 However, data from 1877 patients receiving acitretin therapy showed overt chemical hepatitis in only 0AE26%. 90 A total of 83 patients followed by liver biopsy for 2 years showed no significant hepatotoxicity with acitretin other than mild changes.…”

“…90 A total of 83 patients followed by liver biopsy for 2 years showed no significant hepatotoxicity with acitretin other than mild changes. 97 Alcoholics, diabetics and obese individuals are at increased risk for hepatotoxicity and require more frequent liver function studies.…”

Is concomitant use of methotrexate and oral retinoids dangerous? A review of the data regarding this combination

“…However, methotrexate is hepatotoxic, and acitretin can elevate levels of liver enzymes. [1][2][3][4][5] This led to assumptions about a potentially dangerous drug interaction, thereby prompting explicit warnings as ''contraindication'' against the concomitant use of methotrexate and acitretin. 5,6 These limitations have hindered combination use in treating psoriasis patients, which may be problematic for those who have suffered unsatisfactory response to either agent used as monotherapy or with other modalities.…”

“…Retinoid toxicity is dose dependent, unlike the cumulative effects of methotrexate, and is reversible. 4 This has prompted the recommendation for performing liver function tests to monitor for elevations in transaminases. 12 In June of 1999, more than 50 years after methotrexate was approved for the treatment of cancer, the US Food and Drug Administration (FDA) Advisory Panel modified the package insert for methotrexate, issuing a precaution regarding the potential for increased hepatotoxicity when administered concurrently with retinoids and recommending ''close monitoring of patients.''…”

Sonographic assessment of the liver in children with psoriasis

“…[2][3][4][6][7][8][9]12 This study was undertaken to sonographically assess the condition of the liver in psoriatic children and to compare it with the condition of the liver in a group of healthy children.…”