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

Searles, Alyssa D.; Lee, Andrew D.; Feldman, Steven R.

doi:10.1016/j.jaad.2010.05.007

Cited by 6 publications

(9 citation statements)

References 22 publications

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“…Our findings are in agreement with those of previously published cases that support no increased risk of liver toxicity with combined use of MTX and ACI 1–3 . The authors of one case report concluded that the possibility of toxic hepatitis due to combined use of MTX and the formerly used first‐generation retinoid, etretinate (a pro‐drug of ACI) could not be excluded, 4 but other authors did not observe a hepatotoxic effect 1 . A central pharmacokinetic difference between etretinate and the second‐generation retinoid ACI is that ACI has a shorter half‐life (49 vs. 120 h) and does not accumulate in the adipose tissue, which would increase the risk of a prolonged systemic AE 5,6 .…”

Section: Patient Age Years Sex Indications Comorbidities Monotherapy Concurrent Treatment Regimens Other Drug Use Response Aes Initial Drsupporting

confidence: 92%

Section: Patient Age Years Sex Indications Comorbidities Monotherapy Concurrent Treatment Regimens Other Drug Use Response Aes Initial Drsupporting

confidence: 92%

“…Methotrexate (MTX) and acitretin (ACI) are both widely used drugs for the systemic treatment of dermatological conditions such as psoriasis. As both drugs may potentially be hepatotoxic, drug regulatory agencies warn against their concurrent use, owing to concerns of a synergistic effect that could increase this risk even further 1 . A limited number of cases of combined use of MTX and ACI have been reported to date 1–3 .…”

Section: Patient Age Years Sex Indications Comorbidities Monotherapy Concurrent Treatment Regimens Other Drug Use Response Aes Initial Drmentioning

confidence: 99%

“…As both drugs may potentially be hepatotoxic, drug regulatory agencies warn against their concurrent use, owing to concerns of a synergistic effect that could increase this risk even further 1 . A limited number of cases of combined use of MTX and ACI have been reported to date 1–3 . Although these reports are not suggestive of a safety issue, more data are needed to help address the theoretical concerns on the hepatic safety of these drugs.…”

Section: Patient Age Years Sex Indications Comorbidities Monotherapy Concurrent Treatment Regimens Other Drug Use Response Aes Initial Drmentioning

confidence: 99%

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Safety of the combined use of methotrexate and acitretin in a dermatology hospital setting

et al. 2021

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Section: Patient Age Years Sex Indications Comorbidities Monotherapy Concurrent Treatment Regimens Other Drug Use Response Aes Initial Drsupporting

confidence: 92%

Section: Patient Age Years Sex Indications Comorbidities Monotherapy Concurrent Treatment Regimens Other Drug Use Response Aes Initial Drsupporting

confidence: 92%

Section: Patient Age Years Sex Indications Comorbidities Monotherapy Concurrent Treatment Regimens Other Drug Use Response Aes Initial Drmentioning

confidence: 99%

Section: Patient Age Years Sex Indications Comorbidities Monotherapy Concurrent Treatment Regimens Other Drug Use Response Aes Initial Drmentioning

confidence: 99%

See 2 more Smart Citations

Safety of the combined use of methotrexate and acitretin in a dermatology hospital setting

et al. 2021

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“…The reason is an increased hepatotoxic risk, which resulted in a case of toxic hepatitis in a patient with psoriasis (35). However, a review addressing this issue concluded that the evidence is not strong enough to support a general contraindication regarding the concomitant use of methotrexate and retinoids (36), although consequent laboratory monitoring is mandatory. Out of 116 patients included in this review, 14 patients in 3 studies had concomitant MTX and retinoid therapy with overall response rates of 85.7%, complete clearance in 50% and excellent improvement in 35.7%, with no hepato toxic adverse drug reactions mentioned (20,37,38).…”

Section: Discussionmentioning

confidence: 99%

Methotrexate Treatment for Pityriasis Rubra Pilaris: A Case Series and Literature Review

Koch¹,

Schöffl²,

Aberer³

et al. 2018

Acta Derm Venerol

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Treatment recommendations for pityriasis rubra pilaris (PRP) are based solely on case reports and small case series, as to-date no randomized controlled trials are available. We present here a case series of 3 patients and a literature review of 28 studies treating a total of 116 patients, with the aim of providing data regarding efficacy and safety of methotrexate in the treatment of PRP. Methotrexate was effective in our patients; the review showed an overall response rate of 65.5% with complete clearing in 23.3% and excellent improvement in 17.2%, respectively. After excluding studies with other concurrent systemic therapies or low reliability, the overall response rate increased to 90.9%, with complete clearing in 40.9% and excellent improvement in 31.8%, respectively. Sixteen adverse reactions, of which 11 were mild, were observed in 15 patients (12.9%). In conclusion, the available literature supports good response rates and safety of methotrexate in PRP.

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Pityriasis Rubra Pilaris

Samuelov

Sprecher

2019

Harper's Textbook of Pediatric Dermatology

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

Cited by 6 publications

References 22 publications

Safety of the combined use of methotrexate and acitretin in a dermatology hospital setting

Safety of the combined use of methotrexate and acitretin in a dermatology hospital setting

Methotrexate Treatment for Pityriasis Rubra Pilaris: A Case Series and Literature Review

Pityriasis Rubra Pilaris

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