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Short‐term methotrexate administration by low‐dose infusion—does it influence clearance of psoriasis?
Author(s) -
HARRISON P.V.,
ORRELL D.H.,
JAMES R.,
PEAT M.,
STONES R.N.
Publication year - 1989
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/j.1365-2230.1989.tb01983.x
Subject(s) - methotrexate , psoriasis , medicine , term (time) , administration (probate law) , pharmacology , dermatology , political science , law , physics , quantum mechanics
Summary Twenty‐four patients between them received 86 low‐dose methotrexate infusions (given over 36 or 48 h) delivered by a Graseby syringe pump in addition to conventional topical therapy during hospital admission for treatment of severe psoriasis (either erythrodermic or severe widespread plaque‐type). The average length of hospital stay, usually the time taken to achieve complete clearance, and the average relapse time in the group of patients overall showed no differences from a control group of 25 patients (matched for age and sex) having a similar severity of psoriasis treated without methotrexate. However, separation of the patients into three sub‐groups (erythrodermic, severe and‘unstable’widespread plaque‐type, and severe and 'stable’widespread plaque‐type disease) revealed that erythrodermic patients, as expected, cleared significantly quicker when receiving methotrexate although severe and‘unstable’widespread plaque‐type patients had their clearance times possibly prolonged by short‐term methotrexate administration. Although methotrexate is commonly used for long‐term management of patients with severe psoriasis, short‐term methotrexate administered in this manner cannot necessarily he recommended for severe widespread plaque‐type disease. Measurement of methotrexate levels in a further 24 patients with severe psoriasis receiving 47 low‐dose infusions revealed relatively constant and predictable methotrexate concentrations, Acute side‐effects of methotrexate given by the infusion method were minor and uncommon, the infusion being well tolerated by patients. However, the low‐dose infusion technique did not, apparently, offer any advantage over conventional methotrexate administration.