Document Detail


Drug use and toxicity in psoriatic disease: focus on methotrexate.
MedLine Citation:
PMID:  18609744     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Methotrexate (MTX) toxicity in psoriatic disease was the focus of discussion at the 2007 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). Plenary presentations and results of a Web-based opinion survey of rheumatologists and dermatologists from GRAPPA, and others from New Zealand, Australia, and Canada, provided topics of discussion for small-group breakout sessions, including hepatotoxicity, alcohol use, fertility and pregnancy, and combination therapy. As a framework, topics were considered under headings: importance, knowledge deficit, sufficient data for a recommendation, and research agenda. Breakout session conclusions/consensus were as follows: (1) Data are insufficient to recommend routine serial liver biopsy to prevent MTX-induced liver fibrosis; further research is needed to establish whether serial liver chemistry tests or propeptide of type III collagen can detect hepatotoxicity without the need for liver biopsy. (2) Insufficient data are available to establish a dose-response relationship between alcohol use and MTX hepatotoxicity, so no safe limit of alcohol intake can be recommended. (3) Although cessation of MTX 3 months prior to conception is reasonable, inadequate data are available to specify duration or to quantify the risk of adverse fetal outcome; registries to track pregnancy outcome are potentially useful. (4) Combination therapy with anti-TNF agents or sulfasalazine is safe, but insufficient data are available for combinations with leflunomide or cyclosporine.
Authors:
William J Taylor; Eleanor Korendowych; Peter Nash; Philip S Helliwell; Ernest Choy; Gerald G Krueger; Enrique R Soriano; Neil J McHugh; Cheryl F Rosen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  35     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-08     Completed Date:  2008-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1454-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Otago/Wellington, New Zealand. will.taylor@otago.ac.nz
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MeSH Terms
Descriptor/Qualifier:
Alcoholic Beverages / adverse effects
Antirheumatic Agents / adverse effects*
Female
Humans
Liver Cirrhosis / chemically induced
Methotrexate / adverse effects*
Pregnancy
Psoriasis / drug therapy*
Chemical
Reg. No./Substance:
0/Antirheumatic Agents; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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