Methotrexate in psoriatic arthritis

M. Cutolo, B. Seriolo, C. Pizzorni, C. Craviotto, A. Sulli

Research Laboratory, Division of Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy.

ABSTRACT
Methotrexate (MTX) is a folic acid analogue with antiproliferative and antiinflammatory effects. In the past several years, MTX has become the most commonly used agent in patients with severe, destructive psoriatic arthritis (PsA), with positive clinical results. Liver changes and serum enzyme level increases do not seem to be a major problem in PSA patients treated with MTX. In addition, PSA patients treated with low-dose MTX were not associated with pulmonary fibrosis as evaluated by means of sensitive imaging techniques and pulmonary function tests. The concomitant use of folic acid reduces both the frequency of serum liver enzyme level increases but also the efficacy of MTX by competing with the folate receptors.

Key words
Psoriatic arthritis, methotrexate, folic acid, psoriasis.

Please address correspondence to: Prof. Maurizio Cutolo, MD, Division of Rheumatology, Department of Internal Medicine, University of Genova, Viale Benedetto XV no. 6 16132 Genova, Italy. 
E-mail: mcutolo@unige.it

Clin Exp Rheumatol 2002; 20: (Suppl. 28): S76-S80.
© Copyright Clinical and Experimental Rheumatology 2002.