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The practical use of methotrexate in psoriasis
1Department of Pharmaceutical Services, University of California, San Francisco.
Drugs
|November 1, 1990
Summary
Methotrexate is an effective treatment for severe psoriasis, but its use requires careful patient selection and monitoring due to potential toxicities like liver damage and bone marrow suppression. Safe and effective management involves using the lowest possible dose and awareness of drug interactions.
Area of Science:
- Dermatology
- Pharmacology
- Immunology
Background:
- Psoriasis is a chronic inflammatory skin condition characterized by increased epidermal proliferation.
- Genetic predisposition is suspected, but the exact etiology remains unknown.
- Current therapies aim to reduce epidermal proliferation and inflammation.
Purpose of the Study:
- To review the role and safety of methotrexate in treating severe, recalcitrant psoriasis.
- To highlight the importance of proper patient selection and monitoring for methotrexate therapy.
- To discuss potential toxicities and drug interactions associated with methotrexate.
Main Methods:
- Review of existing literature on methotrexate use in psoriasis treatment.
- Analysis of methotrexate's efficacy, toxicity profile, and management strategies.
- Emphasis on monitoring for adverse effects and patient education.
Main Results:
- Methotrexate is an established alternative for severe psoriasis unresponsive to topical treatments.
- Key toxicities include bone marrow suppression, gastrointestinal issues, and hepatotoxicity.
- Liver biopsies are crucial for monitoring long-term methotrexate therapy.
Conclusions:
- Methotrexate is a valuable treatment for severe psoriasis but necessitates cautious use.
- Close monitoring, appropriate dosage, and awareness of drug interactions are essential for safe and effective treatment.
- Patient education regarding signs of toxicity is critical for prompt management.