Methotrexate

Said, Samireh; Jeffes, Edward W. B.; Weinstein, Gerald D.

doi:10.1016/s0738-081x(97)00014-x

Cited by 48 publications

(33 citation statements)

References 98 publications

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“…7 It has been reported that MTX given daily has led to ulceration of psoriatic plaques, while weekly single doses do not cause this adverse event. 8 The rationale for giving the drug in three divided doses weekly is now thought to be invalid as this regime is associated with a higher risk of patient error. 9,10 As MTX in divided doses is prone to error this may result in an increased risk of cutaneous toxicity.…”

Section: Discussionmentioning

confidence: 99%

Methotrexate toxicity presenting as ulcerated psoriatic plaques

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Methotrexate toxicity presenting as ulcerated psoriatic plaques

et al. 2011

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“…Lek stosuje się raz w tygodniu doustnie lub parenteralnie (domięśniowo lub podskórnie). W przypadku stosowania doustnego lek może być podawany w jednorazowej dawce lub podzielonej na trzy, przyjmowanej w odstępach 12-godzinnych (odstęp czasowy pomiędzy pierwszą dawką a trze cią wynosi 24 godziny), co pozwala na utrzymanie istotnych stężeń leku w surowicy przez dłuższy czas [21,22].…”

Section: Mechanizm Działania Metotreksatuunclassified

Prace poglądowe Folate supplementation in patients with psoriasis treated with methotrexate – effect on safety and efficacy

Żychowska¹,

Batycka-Baran²,

Bieniek³

et al. 2014

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STRESZCZENIEMetotreksat (MTX) jest lekiem powszechnie wykorzystywanym w der matologii, m.in. jako jedna z opcji terapeutycznych u pacjentów z łusz czycą i łuszczycowym zapaleniem stawów. Podstawowym ograni czeniem terapii są działania niepożądane. Do najczęstszych należą: zaburzenia żołądkowo-jelitowe, owrzodzenia w obrębie błon śluzowych jamy ustnej, złe samopoczucie, wypadanie włosów, hepatotoksyczność, supresja szpiku. Sposobem redukcji działań niepożądanych może być suplementacja folianami, tj. kwasem foliowym lub folinowym. Istnie je jednak ryzyko, że zbyt duże dawki folianów mogą ograniczyć sku teczność leczenia. Obecnie brakuje ścisłych wytycznych dotyczących dawkowania kwasu foliowego w trakcie terapii MTX u pacjentów der matologicznych. Po dokonaniu przeglądu bazy danych PubMed (1960marzec 2014 roku), znaleźliśmy jedynie kilka badań, w tym jedno bada nie randomizowane przeprowadzone metodą podwójnie ślepej próby, oceniających wpływ suplementacji na występowanie działań niepożą danych i skuteczność terapii MTX u pacjentów z łuszczycą. Doniesienia te sugerują, że regularna suplementacja może zmniejszać odsetek dzia łań niepożądanych, głównie zaburzeń żołądkowo-jelitowych. Ciągle niejasny jest jednak wpływ suplementacji na skuteczność terapii MTX.ABSTRACT Methotrexate (MTX) is commonly used in dermatology, mainly in pa tients with psoriasis and psoriatic arthritis. Gastrointestinal disorders, mouth ulcerations, malaise, hair loss, hepatic dysfunction and bone marrow suppression are the most common adverse effects of MTX the rapy. The occurrence of side effects is suggested to be the main reason for discontinuation of the therapy. Supplementation with folates seems to be a good strategy in limiting adverse effects; however, excessive doses may decrease the efficacy of MTX therapy. Currently, there are no consistent recommendations for folate supplementation in psoriatic patients. An extensive PubMed search (1960( -March 2014 revealed only a few studies, with one randomized controlled trial concerning the impact of folate supplementation in patients with psoriasis. These studies support the protective effect of folate supplementation and sug gest that folic acid may reduce gastrointestinal disturbances. Further research, including randomized controlled trials, should be performed. SŁOWA KLUCZOWE:metotreksat, kwas foliowy, łuszczyca.

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“…Methotrexate (MTX), a well-known antimetabolite, functions as a folic acid antagonist and is widely used in high doses as a chemotherapeutic agent for the treatment of lymphomas, leukemias and some solid tumors (1). MTX is a well-established immuno-modulating drug that is administered in low doses (low-dose MTX-LDMTX), with concurrent folate supplementation for the treatment of chronic autoimmune and immune-mediated diseases such as rheumatoid arthritis, systemic lupus erythematosus and psoriasis (1,2).…”

Section: Introductionmentioning

confidence: 99%

“…MTX is a well-established immuno-modulating drug that is administered in low doses (low-dose MTX-LDMTX), with concurrent folate supplementation for the treatment of chronic autoimmune and immune-mediated diseases such as rheumatoid arthritis, systemic lupus erythematosus and psoriasis (1,2). …”

Section: Introductionmentioning

confidence: 99%

Atypical methotrexate ulcerative stomatitis with features of lymphoproliferative like disorder: Report of a rare ciprofloxacin-induced case and review of the literature

Katsoulas¹,

Chrysomali²,

Piperi³

et al. 2016

J Clin Exp Dent

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Methotrexate (MTX) is an established immunomodulating agent used in low doses (LDMTX) to treat several autoimmune diseases. Ulcerative stomatitis (US) may be observed as a long-term LDMTX adverse effect showing a wide histopathologic spectrum. A 73-year old female presented with painful oral ulcers of 5 days duration. The patient had been under treatment for rheumatoid arthritis with LDMTX, while one week before presentation she was prescribed ciprofloxacin for a urinary infection. Histopathologic examination of a lingual ulcer revealed a polymorphous lymphohistiocytic proliferation with scattered binucleated atypical lymphocytes. Immunohistochemically, most cells were of T-cell lineage while the EBER test was negative and a diagnosis of MTX-induced reactive ulceration was rendered. MTX cessation resulted in complete resolution of the ulcers with no recurrences reported so far. The clinical and histopathologic features of MTX-induced oral ulcers are not always diagnostic and a detailed history and an extensive clinicopathologic investigation may be needed to exclude a lymphoproliferative disorder. Key words:Atypical oral ulcers, ciprofloxacin, lymphoproliferative disorders, methotrexate.

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Methotrexate

Cited by 48 publications

References 98 publications

Methotrexate toxicity presenting as ulcerated psoriatic plaques

Methotrexate toxicity presenting as ulcerated psoriatic plaques

Prace poglądowe Folate supplementation in patients with psoriasis treated with methotrexate – effect on safety and efficacy

Atypical methotrexate ulcerative stomatitis with features of lymphoproliferative like disorder: Report of a rare ciprofloxacin-induced case and review of the literature

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