Effectiveness and safety of Methotrexate in psoriasis: an eight-year experience with 218 patients

Background: Methotrexate (MTX), a traditional antipsoriatic drug, is very frequently used either as mono-therapy or in combination with other systemic drugs. Objectives: To assess the effectiveness and safety of MTX in psoriasis in usual clinical practice. Methods: We conducted a retrospective study. We performed an electronic and manual chart review of patients treated with MTX in the Psoriasis Unit of our Hospital from January 2007 to December 2014. Demographic and clinical data, PASI/DLQI scores and reasons for suspension of all patients treated with MTX in usual clinical practice were recorded. Results: Two hundred and eighteen patients were included. MTX was administered in 67% of cases as the first systemic treatment. The average treatment duration was 17.2 +/- 13.6 months. All patients were subjected to clinical and laboratory monitoring. About 33.5% of them achieved a reduction of 75% or more of the initial PASI at week 12, 34.9% at week16, 44.7% at week 24, and 52.8% at week 48. A 3.3% had to discontinue the therapy due to analytical hepatic (2.8%) or renal (0.5%) abnormalities. Only one patient experienced severe interstitial pneumonitis and none required liver biopsy. Conclusions: MTX is an effective and safe option for the treatment of psoriasis in the real-world clinical practice.