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Rheumatology Advance Access originally published online on May 12, 2008
Rheumatology 2008 47(7):939-941; doi:10.1093/rheumatology/ken158
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

EDITORIALS

Psoriatic arthritis, methotrexate and the liver—are rheumatologists putting their patients at risk?

K. Lindsay and A. Gough

Harrogate and District NHSFT, Harrogate, N Yorkshire, UK

Correspondence to: K. Lindsay, Harrogate and District NHSFT, Lancaster Park Road, Harrogate, N Yorkshire HG2 7SX, UK. E-mail: Karen.Lindsay@anhst.nhs.uk

The first 150 words of the full text of this article appear below.

It seems hard to believe that in the early 1990s MTX use by a respected group of UK rheumatologists in nine hospitals only represented 3% of all DMARDs used for a cohort of patients presenting with early RA [1]. It is now the most widely used DMARD, not only for RA, but is effective for both psoriasis and PsA [2, 3]. It has also become our principal anchor drug in combination therapy, including the anti-TNF agents, where recent data suggests that their combination is our best treatment option yet in RA [4]. As a cheap, effective and usually well-tolerated drug it is not surprising that prescribing it worldwide has continued to rise exponentially and that the patients may be on it commonly for >5 yrs.

Hepatotoxicity with MTX has always been a concern. In the 1970s, this was the predominant reason for MTX . . . [Full Text of this Article]


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 Rheumatology (Oxford)Home page
K. Lindsay, A. Gough, A. Layton, and S. Fraser
Comment on: Liver fibrosis in patients with psoriasis and psoriatic arthritis on long term, high cumulative dose methotrexate therapy: reply
Rheumatology, November 1, 2009; 48(11): 1465 - 1465.
[Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
K. Lindsay, A. D. Fraser, A. Layton, M. Goodfield, H. Gruss, and A. Gough
Liver fibrosis in patients with psoriasis and psoriatic arthritis on long-term, high cumulative dose methotrexate therapy
Rheumatology, May 1, 2009; 48(5): 569 - 572.
[Abstract] [Full Text] [PDF]