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Methotrexate is used to treat psoriatic arthritis. Several studies have concluded it is effective, thus only the tolerability of the patient should be taken into account when starting methotrexate therapy.

Methotrexate is an effective and safe agent in psoriatic arthritis. In the last decade, methotrexate has emerged as a useful second line agent for a variety of arthritides. However, there still exists some reluctance for its wider use mainly because of concerns about its liver side effects [1].

A study of active psoriatic arthritis found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in psoriatic arthritis [2]. However, this is a 6 month study. The others that claim methotrexate is effective gathered data for more than 6 months [3, 5, 6].

Methotrexate can be used early in the course of psoriatic arthritis with good results [3]. When it comes to long term terapy, methotrexate conferred no advantage with respect to clinical response or longterm damage even after 24 months of therapy [4]. Methotrexate is superior to intramuscular gold in the likelihood of achieving a clinical response and in permitting an individual to continue longterm treatment [5]. When compared to cyclosporin A, one study shows that low-dose cyclosporin A and methotrexate are both effective in the treatment of psoriatic arthritis, but the differences in the tolerability of these drugs must be considered at the start of therapy [6].

In psoriasis, the rate of production of epithelial cells in the skin is greatly increased over normal skin. This differential in proliferation rates is the basis for the use of Methotrexate to control the psoriatic process [7].

 

References:

  1. Espinoza LR, Zakraoui L, Espinoza CG, GutiĂŠrrez F, Jara LJ, Silveira LH, CuĂŠllar ML, MartĂ­nez-Osuna P. Psoriatic arthritis: clinical response and side effects to methotrexate therapy. J. Rheumatol. 1992 Jun;19(6):872-7. PubMed PMID: 1404123.

  2. Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Tom BD, O'Keeffe AG, Maddison PJ, Scott DL. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology (Oxford). 2012 Aug;51(8):1368-77. doi: 10.1093/rheumatology/kes001. PubMed PMID: 22344575.

  3. Singh YN, Verma KK, Kumar A, Malaviya AN. Methotrexate in psoriatic arthritis. J Assoc Physicians India. 1994 Nov;42(11):860-2. PubMed PMID: 7868484.

  4. Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. The Journal of Rheumatology [1995, 22(2):241-245]

  5. Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate? J. Rheumatol. 2000 Aug;27(8):1922-7. PubMed PMID: 10955334.

  6. Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clinical and Experimental Rheumatology [1995, 13(5):589-593]

  7. Drugs.com. Methotrexate

Methotrexate is used to treat psoriatic arthritis. Several studies have concluded it is effective, thus only the tolerability of the patient should be taken into account when starting methotrexate therapy.

Methotrexate is an effective and safe agent in psoriatic arthritis. In the last decade, methotrexate has emerged as a useful second line agent for a variety of arthritides. However, there still exists some reluctance for its wider use mainly because of concerns about its liver side effects [1].

A study of active psoriatic arthritis found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in psoriatic arthritis [2]. However, this is a 6 month study. The others that claim methotrexate is effective gathered data for more than 6 months [3, 5, 6].

Methotrexate can be used early in the course of psoriatic arthritis with good results [3]. When it comes to long term terapy, methotrexate conferred no advantage with respect to clinical response or longterm damage even after 24 months of therapy [4]. Methotrexate is superior to intramuscular gold in the likelihood of achieving a clinical response and in permitting an individual to continue longterm treatment [5]. When compared to cyclosporin A, one study shows that low-dose cyclosporin A and methotrexate are both effective in the treatment of psoriatic arthritis, but the differences in the tolerability of these drugs must be considered at the start of therapy [6].

In psoriasis, the rate of production of epithelial cells in the skin is greatly increased over normal skin. This differential in proliferation rates is the basis for the use of Methotrexate to control the psoriatic process [7].

References:

  1. Espinoza LR, Zakraoui L, Espinoza CG, GutiĂŠrrez F, Jara LJ, Silveira LH, CuĂŠllar ML, MartĂ­nez-Osuna P. Psoriatic arthritis: clinical response and side effects to methotrexate therapy. J. Rheumatol. 1992 Jun;19(6):872-7. PubMed PMID: 1404123.

  2. Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Tom BD, O'Keeffe AG, Maddison PJ, Scott DL. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology (Oxford). 2012 Aug;51(8):1368-77. doi: 10.1093/rheumatology/kes001. PubMed PMID: 22344575.

  3. Singh YN, Verma KK, Kumar A, Malaviya AN. Methotrexate in psoriatic arthritis. J Assoc Physicians India. 1994 Nov;42(11):860-2. PubMed PMID: 7868484.

  4. Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. The Journal of Rheumatology [1995, 22(2):241-245]

  5. Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate? J. Rheumatol. 2000 Aug;27(8):1922-7. PubMed PMID: 10955334.

  6. Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clinical and Experimental Rheumatology [1995, 13(5):589-593]

  7. Drugs.com. Methotrexate

Methotrexate is used to treat psoriatic arthritis. Several studies have concluded it is effective, thus only the tolerability of the patient should be taken into account when starting methotrexate therapy.

Methotrexate is an effective and safe agent in psoriatic arthritis. In the last decade, methotrexate has emerged as a useful second line agent for a variety of arthritides. However, there still exists some reluctance for its wider use mainly because of concerns about its liver side effects [1].

A study of active psoriatic arthritis found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in psoriatic arthritis [2]. However, this is a 6 month study. The others that claim methotrexate is effective gathered data for more than 6 months [3, 5, 6].

Methotrexate can be used early in the course of psoriatic arthritis with good results [3]. When it comes to long term terapy, methotrexate conferred no advantage with respect to clinical response or longterm damage even after 24 months of therapy [4]. Methotrexate is superior to intramuscular gold in the likelihood of achieving a clinical response and in permitting an individual to continue longterm treatment [5]. When compared to cyclosporin A, one study shows that low-dose cyclosporin A and methotrexate are both effective in the treatment of psoriatic arthritis, but the differences in the tolerability of these drugs must be considered at the start of therapy [6].

In psoriasis, the rate of production of epithelial cells in the skin is greatly increased over normal skin. This differential in proliferation rates is the basis for the use of Methotrexate to control the psoriatic process [7].

 

References:

  1. Espinoza LR, Zakraoui L, Espinoza CG, GutiĂŠrrez F, Jara LJ, Silveira LH, CuĂŠllar ML, MartĂ­nez-Osuna P. Psoriatic arthritis: clinical response and side effects to methotrexate therapy. J. Rheumatol. 1992 Jun;19(6):872-7. PubMed PMID: 1404123.

  2. Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Tom BD, O'Keeffe AG, Maddison PJ, Scott DL. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology (Oxford). 2012 Aug;51(8):1368-77. doi: 10.1093/rheumatology/kes001. PubMed PMID: 22344575.

  3. Singh YN, Verma KK, Kumar A, Malaviya AN. Methotrexate in psoriatic arthritis. J Assoc Physicians India. 1994 Nov;42(11):860-2. PubMed PMID: 7868484.

  4. Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. The Journal of Rheumatology [1995, 22(2):241-245]

  5. Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate? J. Rheumatol. 2000 Aug;27(8):1922-7. PubMed PMID: 10955334.

  6. Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clinical and Experimental Rheumatology [1995, 13(5):589-593]

  7. Drugs.com. Methotrexate

4 deleted 673 characters in body
source | link

Methotrexate is used to treat psoriatic arthritis. Several studies have concluded it is effective, thus only the tolerability of the patient should be taken into account when starting methotrexate therapy.

Methotrexate is an effective and safe agent in psoriatic arthritis. In the last decade, methotrexate has emerged as a useful second line agent for a variety of arthritides. However, there still exists some reluctance for its wider use mainly because of concerns about its liver side effects [1].

A study of active psoriatic arthritis found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in psoriatic arthritis [2]. However, this is a 6 month study. The others that claim methotrexate is effective gathered data for more than 6 months [3, 5]5, 6].

Methotrexate can be used early in the course of psoriatic arthritis with good results [3]. When it comes to long term terapy, methotrexate conferred no advantage with respect to clinical response or longterm damage even after 24 months of therapy [4]. Methotrexate is superior to intramuscular gold in the likelihood of achieving a clinical response and in permitting an individual to continue longterm treatment [5]. When compared to cyclosporin A, one study shows that low-dose cyclosporin A and methotrexate are both effective in the treatment of psoriatic arthritis, but the differences in the tolerability of these drugs must be considered at the start of therapy [6].

In psoriasis, the rate of production of epithelial cells in the skin is greatly increased over normal skin. This differential in proliferation rates is the basis for the use of Methotrexate to control the psoriatic process [7].

References:

  1. Espinoza LR, Zakraoui L, Espinoza CG, GutiĂŠrrez F, Jara LJ, Silveira LH, CuĂŠllar ML, MartĂ­nez-Osuna P. Psoriatic arthritis: clinical response and side effects to methotrexate therapy. J. Rheumatol. 1992 Jun;19(6):872-7. PubMed PMID: 1404123.

  2. Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Tom BD, O'Keeffe AG, Maddison PJ, Scott DL. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology (Oxford). 2012 Aug;51(8):1368-77. doi: 10.1093/rheumatology/kes001. PubMed PMID: 22344575.

  3. Singh YN, Verma KK, Kumar A, Malaviya AN. Methotrexate in psoriatic arthritis. J Assoc Physicians India. 1994 Nov;42(11):860-2. PubMed PMID: 7868484.

  4. Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. The Journal of Rheumatology [1995, 22(2):241-245]

  5. Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate? J. Rheumatol. 2000 Aug;27(8):1922-7. PubMed PMID: 10955334.

  6. Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clinical and Experimental Rheumatology [1995, 13(5):589-593]

  7. Drugs.com. Methotrexate

Methotrexate is used to treat psoriatic arthritis. Several studies have concluded it is effective, thus only the tolerability of the patient should be taken into account when starting methotrexate therapy.

Methotrexate is an effective and safe agent in psoriatic arthritis. In the last decade, methotrexate has emerged as a useful second line agent for a variety of arthritides. However, there still exists some reluctance for its wider use mainly because of concerns about its liver side effects [1].

A study of active psoriatic arthritis found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in psoriatic arthritis [2]. However, this is a 6 month study. The others that claim methotrexate is effective gathered data for more than 6 months [3, 5].

Methotrexate can be used early in the course of psoriatic arthritis with good results [3]. When it comes to long term terapy, methotrexate conferred no advantage with respect to clinical response or longterm damage even after 24 months of therapy [4]. Methotrexate is superior to intramuscular gold in the likelihood of achieving a clinical response and in permitting an individual to continue longterm treatment [5]. When compared to cyclosporin A, one study shows that low-dose cyclosporin A and methotrexate are both effective in the treatment of psoriatic arthritis, but the differences in the tolerability of these drugs must be considered at the start of therapy [6].

In psoriasis, the rate of production of epithelial cells in the skin is greatly increased over normal skin. This differential in proliferation rates is the basis for the use of Methotrexate to control the psoriatic process [7].

References:

  1. Espinoza LR, Zakraoui L, Espinoza CG, GutiĂŠrrez F, Jara LJ, Silveira LH, CuĂŠllar ML, MartĂ­nez-Osuna P. Psoriatic arthritis: clinical response and side effects to methotrexate therapy. J. Rheumatol. 1992 Jun;19(6):872-7. PubMed PMID: 1404123.

  2. Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Tom BD, O'Keeffe AG, Maddison PJ, Scott DL. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology (Oxford). 2012 Aug;51(8):1368-77. doi: 10.1093/rheumatology/kes001. PubMed PMID: 22344575.

  3. Singh YN, Verma KK, Kumar A, Malaviya AN. Methotrexate in psoriatic arthritis. J Assoc Physicians India. 1994 Nov;42(11):860-2. PubMed PMID: 7868484.

  4. Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. The Journal of Rheumatology [1995, 22(2):241-245]

  5. Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate? J. Rheumatol. 2000 Aug;27(8):1922-7. PubMed PMID: 10955334.

  6. Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clinical and Experimental Rheumatology [1995, 13(5):589-593]

  7. Drugs.com. Methotrexate

Methotrexate is used to treat psoriatic arthritis. Several studies have concluded it is effective, thus only the tolerability of the patient should be taken into account when starting methotrexate therapy.

Methotrexate is an effective and safe agent in psoriatic arthritis. In the last decade, methotrexate has emerged as a useful second line agent for a variety of arthritides. However, there still exists some reluctance for its wider use mainly because of concerns about its liver side effects [1].

A study of active psoriatic arthritis found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in psoriatic arthritis [2]. However, this is a 6 month study. The others that claim methotrexate is effective gathered data for more than 6 months [3, 5, 6].

Methotrexate can be used early in the course of psoriatic arthritis with good results [3]. When it comes to long term terapy, methotrexate conferred no advantage with respect to clinical response or longterm damage even after 24 months of therapy [4]. Methotrexate is superior to intramuscular gold in the likelihood of achieving a clinical response and in permitting an individual to continue longterm treatment [5]. When compared to cyclosporin A, one study shows that low-dose cyclosporin A and methotrexate are both effective in the treatment of psoriatic arthritis, but the differences in the tolerability of these drugs must be considered at the start of therapy [6].

In psoriasis, the rate of production of epithelial cells in the skin is greatly increased over normal skin. This differential in proliferation rates is the basis for the use of Methotrexate to control the psoriatic process [7].

References:

  1. Espinoza LR, Zakraoui L, Espinoza CG, GutiĂŠrrez F, Jara LJ, Silveira LH, CuĂŠllar ML, MartĂ­nez-Osuna P. Psoriatic arthritis: clinical response and side effects to methotrexate therapy. J. Rheumatol. 1992 Jun;19(6):872-7. PubMed PMID: 1404123.

  2. Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Tom BD, O'Keeffe AG, Maddison PJ, Scott DL. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology (Oxford). 2012 Aug;51(8):1368-77. doi: 10.1093/rheumatology/kes001. PubMed PMID: 22344575.

  3. Singh YN, Verma KK, Kumar A, Malaviya AN. Methotrexate in psoriatic arthritis. J Assoc Physicians India. 1994 Nov;42(11):860-2. PubMed PMID: 7868484.

  4. Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. The Journal of Rheumatology [1995, 22(2):241-245]

  5. Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate? J. Rheumatol. 2000 Aug;27(8):1922-7. PubMed PMID: 10955334.

  6. Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clinical and Experimental Rheumatology [1995, 13(5):589-593]

  7. Drugs.com. Methotrexate

3 deleted 673 characters in body
source | link

Methotrexate is used to treat psoriatic arthritis. Several studies have concluded it is effective, thus only the tolerability of the patient should be taken into account when starting methotrexate therapy.

Methotrexate is an effective and safe agent in psoriatic arthritis. In the last decade, methotrexate has emerged as a useful second line agent for a variety of arthritides. However, there still exists some reluctance for its wider use mainly because of concerns about its liver side effects [1].

A study of active psoriatic arthritis found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in psoriatic arthritis [2].

Synovitis is the medical term for inflammation of the synovial membrane. Synovitis may occur in association with arthritis as well as lupus, goutHowever, and other conditions [3]. Arthritisthis is a form of joint disorder that involves inflammation of one or more joints. Synovitis is an extra-articular affection of joint disease [4]6 month study.

In 1964, it was believed The others that claim methotrexate should be reservedis effective gathered data for patients with severe disabling disease who have failed to respond to more conservative measures because of its side effects like anorexia, nausea and lymphopeniathan 6 months [5][3, 5].

Methotrexate can be used early in the course of psoriatic arthritis with good results [6][3]. When it comes to long term terapy, methotrexate conferred no advantage with respect to clinical response or longterm damage even after 24 months of therapy [7][4]. Methotrexate is superior to intramuscular goldsuperior to intramuscular gold in the likelihood of achieving a clinical response and in permitting an individual to continue longterm treatment [8][5]. When compared to cyclosporin A, one study shows that low-dose cyclosporin A and methotrexate are both effective in the treatment of psoriatic arthritis, but the differences in the tolerability of these drugs must be considered at the start of therapy [9][6].

The mechanismIn psoriasis, the rate of actionproduction of epithelial cells in rheumatoid arthritisthe skin is unknown; it may affect immune functiongreatly increased over normal skin. Two reports describeThis differential in vitro Methotrexate inhibitionproliferation rates is the basis for the use of DNA precursor uptake by stimulated mononuclear cells, and another describes in animal polyarthritis partial correction by Methotrexate of spleen cell hyporesponsiveness and suppressed IL 2 production. Other laboratories, however, have been unable to demonstrate similar effects. Clarification of Methotrexate’s effect on immune activity and its relation to rheumatoid immunopathogenesis await further studiescontrol the psoriatic process [10][7].

In conclusion, methotrexate is a good treatment for psoriatic arthritis. When compared to other medication for psoriatic arthritis it proves to be effective starting from the early stages of arthritis. When prescribing it, the tolerability of the patient should be taken into account.

References:

  1. Espinoza LR, Zakraoui L, Espinoza CG, Gutiérrez F, Jara LJ, Silveira LH, Cuéllar ML, Martínez-Osuna P. Psoriatic arthritis: clinical response and side effects to methotrexate therapy.
  2. Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Tom BD, O'Keeffe AG, Maddison PJ, Scott DL. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis.
  3. Wikipedia, Synovitis
  4. Wikipedia, Arthritis

    Espinoza LR, Zakraoui L, Espinoza CG, GutiĂŠrrez F, Jara LJ, Silveira LH, CuĂŠllar ML, MartĂ­nez-Osuna P. Psoriatic arthritis: clinical response and side effects to methotrexate therapy. J. Rheumatol. 1992 Jun;19(6):872-7. PubMed PMID: 1404123.

  5. Roger L. Black, MD; William M. O'Brien, MD; Eugene J. Van Scott, MD; Robert Auerbach, MD; Arthur Z. Eisen, MD; Joseph J. Bunim, MD. Methotrexate Therapy in Psoriatic Arthritis - Double-Blind Study on 21 Patients

    Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Tom BD, O'Keeffe AG, Maddison PJ, Scott DL. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology (Oxford). 2012 Aug;51(8):1368-77. doi: 10.1093/rheumatology/kes001. PubMed PMID: 22344575.

  6. Singh YN, Verma KK, Kumar A, Malaviya AN. Methotrexate in psoriatic arthritis.

    Singh YN, Verma KK, Kumar A, Malaviya AN. Methotrexate in psoriatic arthritis. J Assoc Physicians India. 1994 Nov;42(11):860-2. PubMed PMID: 7868484.

  7. Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome.

    Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. The Journal of Rheumatology [1995, 22(2):241-245]

  8. Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate?

    Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate? J. Rheumatol. 2000 Aug;27(8):1922-7. PubMed PMID: 10955334.

  9. Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study.

    Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clinical and Experimental Rheumatology [1995, 13(5):589-593]

  10. Drugs.com. Methotrexate

    Drugs.com. Methotrexate

Methotrexate is an effective and safe agent in psoriatic arthritis. In the last decade, methotrexate has emerged as a useful second line agent for a variety of arthritides. However, there still exists some reluctance for its wider use mainly because of concerns about its liver side effects [1].

A study of active psoriatic arthritis found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in psoriatic arthritis [2].

Synovitis is the medical term for inflammation of the synovial membrane. Synovitis may occur in association with arthritis as well as lupus, gout, and other conditions [3]. Arthritis is a form of joint disorder that involves inflammation of one or more joints. Synovitis is an extra-articular affection of joint disease [4].

In 1964, it was believed that methotrexate should be reserved for patients with severe disabling disease who have failed to respond to more conservative measures because of its side effects like anorexia, nausea and lymphopenia [5].

Methotrexate can be used early in the course of psoriatic arthritis with good results [6]. When it comes to long term terapy, methotrexate conferred no advantage with respect to clinical response or longterm damage even after 24 months of therapy [7]. Methotrexate is superior to intramuscular gold in the likelihood of achieving a clinical response and in permitting an individual to continue longterm treatment [8]. When compared to cyclosporin A, one study shows that low-dose cyclosporin A and methotrexate are both effective in the treatment of psoriatic arthritis, but the differences in the tolerability of these drugs must be considered at the start of therapy [9].

The mechanism of action in rheumatoid arthritis is unknown; it may affect immune function. Two reports describe in vitro Methotrexate inhibition of DNA precursor uptake by stimulated mononuclear cells, and another describes in animal polyarthritis partial correction by Methotrexate of spleen cell hyporesponsiveness and suppressed IL 2 production. Other laboratories, however, have been unable to demonstrate similar effects. Clarification of Methotrexate’s effect on immune activity and its relation to rheumatoid immunopathogenesis await further studies [10].

In conclusion, methotrexate is a good treatment for psoriatic arthritis. When compared to other medication for psoriatic arthritis it proves to be effective starting from the early stages of arthritis. When prescribing it, the tolerability of the patient should be taken into account.

References:

  1. Espinoza LR, Zakraoui L, Espinoza CG, Gutiérrez F, Jara LJ, Silveira LH, Cuéllar ML, Martínez-Osuna P. Psoriatic arthritis: clinical response and side effects to methotrexate therapy.
  2. Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Tom BD, O'Keeffe AG, Maddison PJ, Scott DL. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis.
  3. Wikipedia, Synovitis
  4. Wikipedia, Arthritis
  5. Roger L. Black, MD; William M. O'Brien, MD; Eugene J. Van Scott, MD; Robert Auerbach, MD; Arthur Z. Eisen, MD; Joseph J. Bunim, MD. Methotrexate Therapy in Psoriatic Arthritis - Double-Blind Study on 21 Patients
  6. Singh YN, Verma KK, Kumar A, Malaviya AN. Methotrexate in psoriatic arthritis.
  7. Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome.
  8. Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate?
  9. Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study.
  10. Drugs.com. Methotrexate

Methotrexate is used to treat psoriatic arthritis. Several studies have concluded it is effective, thus only the tolerability of the patient should be taken into account when starting methotrexate therapy.

Methotrexate is an effective and safe agent in psoriatic arthritis. In the last decade, methotrexate has emerged as a useful second line agent for a variety of arthritides. However, there still exists some reluctance for its wider use mainly because of concerns about its liver side effects [1].

A study of active psoriatic arthritis found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in psoriatic arthritis [2]. However, this is a 6 month study. The others that claim methotrexate is effective gathered data for more than 6 months [3, 5].

Methotrexate can be used early in the course of psoriatic arthritis with good results [3]. When it comes to long term terapy, methotrexate conferred no advantage with respect to clinical response or longterm damage even after 24 months of therapy [4]. Methotrexate is superior to intramuscular gold in the likelihood of achieving a clinical response and in permitting an individual to continue longterm treatment [5]. When compared to cyclosporin A, one study shows that low-dose cyclosporin A and methotrexate are both effective in the treatment of psoriatic arthritis, but the differences in the tolerability of these drugs must be considered at the start of therapy [6].

In psoriasis, the rate of production of epithelial cells in the skin is greatly increased over normal skin. This differential in proliferation rates is the basis for the use of Methotrexate to control the psoriatic process [7].

References:

  1. Espinoza LR, Zakraoui L, Espinoza CG, GutiĂŠrrez F, Jara LJ, Silveira LH, CuĂŠllar ML, MartĂ­nez-Osuna P. Psoriatic arthritis: clinical response and side effects to methotrexate therapy. J. Rheumatol. 1992 Jun;19(6):872-7. PubMed PMID: 1404123.

  2. Kingsley GH, Kowalczyk A, Taylor H, Ibrahim F, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Tom BD, O'Keeffe AG, Maddison PJ, Scott DL. A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology (Oxford). 2012 Aug;51(8):1368-77. doi: 10.1093/rheumatology/kes001. PubMed PMID: 22344575.

  3. Singh YN, Verma KK, Kumar A, Malaviya AN. Methotrexate in psoriatic arthritis. J Assoc Physicians India. 1994 Nov;42(11):860-2. PubMed PMID: 7868484.

  4. Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. The Journal of Rheumatology [1995, 22(2):241-245]

  5. Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate? J. Rheumatol. 2000 Aug;27(8):1922-7. PubMed PMID: 10955334.

  6. Spadaro A, Riccieri V, Sili-Scavalli A, Sensi F, Taccari E, Zoppini A. Comparison of cyclosporin A and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study. Clinical and Experimental Rheumatology [1995, 13(5):589-593]

  7. Drugs.com. Methotrexate

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