Related Experiment Video

Updated: May 15, 2026

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
04:50

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

Adverse effects of methotrexate in three psoriatic arthritis patients

Hideki Maejima1, Akira Watarai, Toshiaki Nakano

  • 1Department of Dermatology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0374, Japan, hm4765@yahoo.co.jp.

Rheumatology International
|January 1, 2013
PubMed

Insights

Methotrexate (MTX) effectively treats psoriatic arthritis but can cause rare adverse effects. This study highlights asymptomatic tuberculosis, renal cell carcinoma, and uveitis as potential risks requiring physician awareness.

Area of Science:

  • Rheumatology
  • Pharmacology
  • Oncology

Background:

  • Methotrexate (MTX), a folic acid antagonist, is a cornerstone therapy for severe psoriatic arthritis due to its anti-proliferative and anti-inflammatory properties.
  • Combination therapy with anti-tumor necrosis factor agents and MTX can improve treatment adherence by reducing adverse event-related discontinuation.

Observation:

  • While MTX is generally well-tolerated, known toxicities include hepatic, pulmonary, and renal damage, alongside risks of infection and lymphoproliferative disorders.
  • This report details three rare MTX-associated adverse events in psoriatic arthritis patients: asymptomatic pulmonary tuberculosis, renal cell carcinoma, and lateral uveitis.

Findings:

  • The study identifies and documents rare but serious adverse effects associated with MTX treatment in psoriatic arthritis patients.
  • Specific rare adverse events observed include asymptomatic pulmonary tuberculosis, renal cell carcinoma, and lateral uveitis.

Implications:

  • Increased physician awareness of these rare adverse effects is crucial for timely diagnosis and management in psoriatic arthritis patients on MTX.
  • Monitoring for these specific conditions may be warranted in patients receiving MTX for psoriatic arthritis, despite its overall efficacy.

More Related Videos

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis11:39

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

Related Concept Videos

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.
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...
Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase01:11

Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase

Genetic polymorphisms in drug targets have emerged as critical determinants of interindividual variability in drug response and toxicity. Pharmacogenomic investigations increasingly focus on identifying these variations to personalize and optimize therapeutic interventions. A drug target may be a receptor, enzyme, or signaling protein involved in pharmacologic responses or disease-related pathways. While early pharmacogenetic studies focused primarily on drug metabolism, current research...
Combined Effects of Drugs: Synergism01:27

Combined Effects of Drugs: Synergism

Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...