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Methotrexate and liver function: a study of 13 psoriasis cases treated with different cumulative dosages
Author(s) -
Carneiro SC,
Cássia FF,
Lamy F,
Chagas VLA,
RamoseSilva M
Publication year - 2008
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/j.1468-3083.2007.02322.x
Subject(s) - medicine , dose , cumulative dose , methotrexate , psoriasis , liver biopsy , toxicity , biopsy , liver function , liver function tests , gastroenterology , liver disease , surgery , dermatology
Background The need and frequency of hepatic biopsies during methotrexate (MTX) therapy are still controversial. Objectives The purpose of this investigation is to assess MTX liver toxicity in patients with psoriasis through percutaneous liver biopsy, and compare liver morphology changes with increasing cumulative dosages (1, 2, 3 and 4 g) of MTX. Results Cumulative dosages of 1 to 2 g MTX did not cause significant liver toxicity. From a cumulative dosage of 3 to 4 g, there is fibrosis formation, inflammation enhancement in the portal area and fibrous septa, configuring regenerative nodes. Conclusion In patients with no risk factors for liver disease, with normal physical examination and liver tests, biopsy can be done after a cumulative MTX dosage of approximately 1 to 1.5 g and repeated for each gram. In patients with risk factors, liver biopsy should be done before use of MTX, or within the first 2 months of treatment at the most, and repeated for each gram of cumulative dosage.