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Insights on methotrexate in psoriatic disease
Jacqueline E Greb1, Ari M Goldminz1, Alice B Gottlieb2
1Department of Dermatology, Tufts Medical Center, 800 Washington Street, Box 114, Boston, Massachusetts, 02111, USA; Tufts University School of Medicine, 136 Harrison Avenue, Boston, Massachusetts, 02111, USA.
Clinical Immunology (Orlando, Fla.)
|July 27, 2016
Summary
Methotrexate, a folic acid analogue, is a crucial first-line treatment for chronic inflammatory and psoriatic diseases. This review covers its clinical evidence, anti-inflammatory mechanisms, and future applications in immune-mediated disorders.
Area of Science:
- Rheumatology and Immunology
- Dermatology
- Oncology
Background:
- Methotrexate (MTX) is a folic acid antagonist widely used for neoplastic diseases.
- It remains a cornerstone therapy for various chronic inflammatory conditions like psoriasis, dermatomyositis, lupus erythematosus, sarcoidosis, and systemic sclerosis.
- Despite advancements in biologic agents, MTX is often a first-line treatment choice.
Purpose of the Study:
- To review the clinical evidence supporting methotrexate's efficacy in psoriatic disease.
- To elucidate the current understanding of methotrexate's anti-inflammatory mechanisms.
- To discuss the potential future role of methotrexate in managing immune-mediated disorders.
Main Methods:
- Literature review of clinical trials and observational studies.
- Analysis of preclinical and clinical data on methotrexate's immunomodulatory effects.
- Synthesis of current therapeutic guidelines and expert opinions.
Main Results:
- Methotrexate demonstrates significant efficacy in managing psoriatic arthritis and psoriasis.
- Its anti-inflammatory actions involve multiple pathways, including adenosine release and cytokine modulation.
- Evidence supports its continued role, particularly in combination therapies.
Conclusions:
- Methotrexate remains a vital therapeutic option for psoriatic disease and other immune-mediated inflammatory disorders.
- Further research into its mechanisms may reveal novel therapeutic strategies.
- Its established safety profile and cost-effectiveness support its ongoing use.
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