Related Experiment Video

Updated: Aug 6, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
11:39

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

Liver injury in long-term methotrexate treatment in psoriasis is relatively infrequent

M A M Berends1, J Snoek, E M G J de Jong

  • 1Department of Dermatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. m.berends@derma.umcn.nl

Alimentary Pharmacology & Therapeutics
|August 22, 2006
PubMed
Abstract

Insights

Methotrexate liver injury in psoriasis patients is less common than believed, with diabetes and obesity as key risk factors. Most liver damage occurred at cumulative doses under 6,000 mg.

Area of Science:

  • Dermatology
  • Hepatology
  • Pharmacology

Background:

  • Psoriasis treatment guidelines recommend liver monitoring due to concerns about methotrexate hepatotoxicity.
  • Emerging data suggests methotrexate may be less liver toxic than previously understood.

Purpose of the Study:

  • To assess the frequency and progression of liver injury in patients with psoriasis treated with methotrexate.
  • To identify risk factors associated with methotrexate-induced liver damage.

Main Methods:

  • Retrospective chart review of 125 psoriasis patients treated between 1976 and 2005.
  • Analysis of 278 liver biopsies to evaluate histology.
  • Statistical analysis to determine associations between methotrexate dosage, treatment duration, and liver injury.

Main Results:

  • Liver injury was observed but generally mild (71% Roenigk grade I).
  • Obesity and diabetes were significant risk factors for liver injury.
  • Liver histology did not change in 72% of patients with multiple biopsies; deterioration occurred in 25%.

Conclusions:

  • Methotrexate-related liver injury in psoriasis patients is less frequent than previously assumed.
  • Significant liver injury typically occurred at cumulative doses below 6,000 mg.
  • Diabetes and overweight status are strongly correlated with methotrexate hepatotoxicity.

More Related Videos

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver09:02

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

Published on: July 31, 2016

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
Antiprotozoal Agents01:21

Antiprotozoal Agents

Leishmaniasis is a widespread parasitic disease caused by several Leishmania species. It affects millions of people each year and remains a major public health problem in endemic regions. First-line treatment relies on pentavalent antimonials, including meglumine antimoniate and sodium stibogluconate. Even so, how these drugs work has not been fully clear, especially their interaction with parasite-specific biochemical pathways. One key target is trypanothione reductase (TR), an enzyme that...