Use of methotrexate in psoriasis

Roenigk, Henry H.

doi:10.1001/archderm.105.3.363

Cited by 18 publications

(10 citation statements)

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“…Low-dose methotrexate therapy has been a mainstay in the treatment of psoriasis for several decades. [3][4][5][6][7][8] Methotrexate in high doses is used successfully in chemotherapy. The relatively low doses used to treat autoimmune disease do not provide the cell kill necessary for cancer therapy; therefore, the mechanisms of action of methotrexate in these 2 diseases are likely to be different.…”

Section: Discussionmentioning

confidence: 99%

Urinary Adenosine and Aminoimidazolecarboxamide Excretion in Methotrexate-Treated Patients With Psoriasis

Baggott¹,

Morgan²,

Sams³

et al. 1999

Arch Dermatol

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Section: Discussionmentioning

confidence: 99%

Urinary Adenosine and Aminoimidazolecarboxamide Excretion in Methotrexate-Treated Patients With Psoriasis

Baggott¹,

Morgan²,

Sams³

et al. 1999

Arch Dermatol

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“…M ethotrexate (MTX) is widely used in the treatment of severe forms of psoriasis and psoriatic arthritis. A number of studies have documented its efficacy and the high degree of patient compliance (1)(2)(3)(4)(5).…”

mentioning

confidence: 99%

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

Ross

et al. 1996

Canadian Journal of Gastroenterology

128

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In this first Canadian study evaluating MTX hepatotoxicity in psoriatics, the incidence of severe hepatotoxicity is high: 23.1% (24 of 104 patients). This study shows that diabetic patients are particularly at increased risk of MTX hepatotoxicity. Occasional alcohol consumption is not associated with increased risk. Three patients who developed cirrhosis over two years of standard MTX therapy may represent a subset of psoriatics with increased hepatic susceptibility to MTX. Another three patients whose severe hepatic fibrosis had regressed upon discontinuation of MTX, but who developed accelerated recurrence of the severe hepatic fibrosis upon resumption of MTX therapy, also suggest the possibility of unusual sensitivity to the drug. These cases emphasize the need for continuing surveillance, with regular liver biopsies, of psoriatic patients on MTX.

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“…Low dose MTX in psoriasis rarely produces toxicity, and most of such cases occur due to failure to adhere to the recommended guidelines [1]. The risk of toxicity is greater if additional methotrexate is administered sooner than the usual scheduled weekly dose [3].…”

Section: Discussionmentioning

confidence: 99%

“…Low dose MTX is an effective and safe treatment for psoriasis being used for more than 50 years [1]. Renal excretion is the primary route of elimination and is dependent upon dosage and route of administration [2].…”

Section: Introductionmentioning

confidence: 99%

Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis

Jariwala

Kumar

Kothari

et al. 2014

Case Reports in Dermatological Medicine

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We describe two fatal cases of low dose methotrexate (MTX) toxicity in patients with psoriasis, emphasizing the factors that exacerbate MTX toxicity. The first patient was a 50-year-old male of psoriasis on intermittent treatment with MTX. After a treatment-free period of six months, he had self-medication of MTX along with analgesic for joint pain for one week which followed ulceration of the lesions, bone marrow suppression, and eventually death. The second patient was a 37-year-old male of psoriasis, who has taken MTX one week earlier without prior investigations. He had painful ulcerated skin lesions and bone marrow suppression. On investigations, he showed high creatinine level and atrophied, nonfunctioning right kidney on ultrasonography. In spite of dialysis, he succumbed to death. MTX is safe and effective if monitored properly, but inadvertent use may lead to even death also. Prior workup and proper counseling regarding the drug interactions as well as self-medication should be enforced.

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Use of methotrexate in psoriasis

Cited by 18 publications

References 0 publications

Urinary Adenosine and Aminoimidazolecarboxamide Excretion in Methotrexate-Treated Patients With Psoriasis

Urinary Adenosine and Aminoimidazolecarboxamide Excretion in Methotrexate-Treated Patients With Psoriasis

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

Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis

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