Methotrexate Hepatotoxicity in Psoriatics: Report of 104 Patients from Nova Scotia, with Analysis of Risks from Obesity, Diabetes and Alcohol Consumption During Long Term Follow‐Up

Malatjalian, D. A.; Ross, Jonathan M.; Cn, Williams; Colwell, SJ; Eastwood, BJ

doi:10.1155/1996/213596

Cited by 130 publications

(98 citation statements)

References 26 publications

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“…On account of the relationship between obesity and other disorders, such as MS or NAFLD, there is an increased risk of adverse effects induced by drugs and loss of therapeutic response [72,73]. In methotrexate-treated patients with psoriasis obesity was shown to be a greater risk factor for hepatotoxicity than alcohol, viral hepatitis or cumulative drug dose [74]. Obese patients with psoriasis treated with cyclosporin A are at an increased risk of nephrotoxicity, which is why the dose of the drug should be adjusted based on the patient's ideal rather than the actual body weight [72].…”

Section: Psoriasis Treatment and Lipid Disordersmentioning

confidence: 99%

“…Ze względu na związek otyłości z innymi zaburzeniami, takimi jak MS czy NAFLD, zwiększa się ryzyko wystąpienia działań niepożądanych leków, a także utraty odpowiedzi na leczenie [72,73]. U pacjentów z łuszczycą leczonych metotreksatem wykazano, że otyłość była większym czynnikiem ryzyka hepatotoksyczności niż alkohol, wirusowe zapalenie wątroby czy dawka kumulacyjna leku [74]. U otyłych osób z łuszczycą przyjmujących cyklosporynę A występuje większe ryzyko nefrotoksyczności, dlatego też zaleca się ustalanie dawki leku wg idealnej masy ciała chorego, a nie aktualnej [72].…”

Section: Psoriasis Treatment and Lipid Disordersunclassified

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The role of lipids in psoriasis

Baran¹,

Kiluk²,

Myśliwiec³

et al. 2017

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Psoriasis, affecting 2-4% of the world's population, is a chronic recurrent inflammatory skin disease. Its multifactorial aetiopathogenesis consists of, for example, abnormal epidermal proliferation, immune disturbances, and genetic, psychosomatic, environmental and hormonal factors. Psoriasis is also considered to be a systemic disorder closely associated with cardiovascular diseases, atherosclerosis, diabetes mellitus, obesity or metabolic syndrome. Lipids have a variety of biological functions. They participate not only in energy storage and expenditure or the formation of cell membranes, but also in inflammatory and metabolic signalling pathways. Disturbances in their homeostasis lead to the development of immunometabolic disorders, including psoriasis. Based on the available literature, this article presents selected molecular and clinical aspects involved in the multidirectional effect of lipids on psoriasis.streszczenie Łuszczyca, która występuje u 2-4% populacji na świecie, jest przewlekłą i nawrotową chorobą zapalną skóry. Na jej wieloczynnikową etiopatogenezę składają się m.in. nieprawidłowa proliferacja naskórka, zaburzenia immunologiczne, czynniki genetyczne, psychosomatyczne, środowiskowe i hormonalne. Łuszczyca jest również uznawana za schorzenie ogólnoustrojowe, związane z chorobami układu sercowo--naczyniowego, miażdżycą, cukrzycą, otyłością i zespołem metabolicznym. Lipidy pełnią wiele biologicznych funkcji, biorą udział nie tylko w magazynowaniu i wydatkowaniu energii, tworzeniu błon komórko-wych, lecz także w zapalnych i metabolicznych szlakach sygnałowych. Zaburzenia ich homeostazy powodują rozwój schorzeń immunometabolicznych, w tym łuszczycy. W niniejszej pracy przedstawiono na podstawie dostępnego piśmiennictwa wybrane aspekty molekularne i kliniczne wielokierunkowego wpływu lipidów na łuszczycę.

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Section: Psoriasis Treatment and Lipid Disordersmentioning

confidence: 99%

Section: Psoriasis Treatment and Lipid Disordersunclassified

The role of lipids in psoriasis

Baran¹,

Kiluk²,

Myśliwiec³

et al. 2017

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“…In a study from 1996, a series of 104 patients with psoriasis were treated with methotrexate over a period of 3.4 years. 83 86 Rare cases have been reported in patients with IBD. 82,87 Pretreatment chest X-ray or pulmonary function tests are not routinely ordered, but a high clinical suspicion is essential if pulmonary symptoms begin during treatment.…”

Section: Toxicitymentioning

confidence: 99%

Review article: practical management of inflammatory bowel disease patients taking immunomodulators

Siegel

Sands

2005

Aliment Pharmacol Ther

107

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SUMMARYAzathioprine, mercaptopurine, methotrexate, ciclosporin and tacrolimus all have their respective niches in the treatment of inflammatory bowel disease. These immunomodulators are potent and effective medications; however, they potentially have serious toxicity. To maximize benefit and minimize risk, clinicians must understand the mechanism of action, appropriate indications, range of toxicity and proper dosing of these medications. Furthermore, once initiating therapy, patients need to be monitored appropriately for evidence of efficacy and toxicity.This review includes the rationale behind recommendations for the management and monitoring of patients using immunomodulators. For the purine antagonists -azathioprine and mercaptopurine -the evidence for utility of thiopurine methyltransferase testing and mercaptopurine metabolite monitoring is addressed. The roles of liver biopsy and screening for methylenetetrahydrofolate reductase mutations in patients taking methotrexate are reviewed. With appropriate monitoring, the calcineurin inhibitorsciclosporin and tacrolimus -can be used safely and effectively. Immunomodulators are important agents for the treatment of Crohn's disease and ulcerative colitis, and prescribing clinicians should be comfortable recognizing both their value and their limitations.

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“…Many risk factors such as age, duration of exposure to MTX and its cumulative dose, history of Non Alcoholic Steatohepatitis (NASH), diabetes and obesity, hepatitis B or C virus infection, alcohol consumption and hepatotoxic drugs can increase the hepatotoxic effect of MTX (Lorenz and Knudtson, 2007;Diouf et al, 2001;Visser et al, 2009;Jones and Patel, 2000;Kremer et al, 1995;Langman et al, 2001;Leonard et al, 1987;Malatjalian et al, 1996;Reynold and Lee, 1986;Salliot, C. and Heijde D.V.D., 2009;Walker et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

Hepatoprotective Effect of Taurine Against Oxidative Stress Due to Methotrexate in Rat

Issabeagloo¹,

Taghizadiyeh²,

Kermanizadeh³

2011

American Journal of Animal and Veterinary Sciences

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Problem statement: Taurine, 2-aminoethanesulphonic acid is an essential amino acid. It is present at high concentrations in many tissues. It plays important roles in numerous physiological functions including conjugation with bile acids, modulation of calcium levels and maintenance of osmolarity, antioxidation and stabilization of membranes. Methotrexate (MTX), as the most disease modifying anti-rheumatic drug used for Rheumatoid Arthritis (RA), has been available for clinical use since 1951. The main scope of this study was to assessment of probable Hepatoprotective effect of taurine as it antioxidant action against oxidative stress due to methotrexate in rats. Approach: Eighty male Wistar rats, weighing 200±20 gr, were obtained from the animal breeding center of Islamic Azad University. The rats were divided into 4 equal groups of 20 animals including: 1-normal control, 2-normal rats treated with taurine, 3-taurine + methotrexate and 4-methotrexate. Results: Methotrexateinduced hepatotoxicity as reflected by elevated serum ALT, AST and GGT levels (p<0.001) and reduced serum total protein level (p<0.001). Conclusion: Taurine has a protective action against hepatotoxins and suggest that taurine may find clinical application against a variety of toxins where cellular damage is a consequence of reactive oxygen species.

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Methotrexate Hepatotoxicity in Psoriatics: Report of 104 Patients from Nova Scotia, with Analysis of Risks from Obesity, Diabetes and Alcohol Consumption During Long Term Follow‐Up

Cited by 130 publications

References 26 publications

The role of lipids in psoriasis

The role of lipids in psoriasis

Review article: practical management of inflammatory bowel disease patients taking immunomodulators

Hepatoprotective Effect of Taurine Against Oxidative Stress Due to Methotrexate in Rat

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