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Methotrexate for Psoriasis in Weekly Oral Doses

Methotrexate for Psoriasis in Weekly Oral Doses Abstract A clinical evaluation is presented of 204 severe psoriatic patients treated with methotrexate, 25 mg (ten tablets) orally at weekly intervals. Preliminary evaluation of hepatic and renal function is mandatory. The mean age of patients was 44 years; mean duration of psoriasis before methotrexate therapy was 10 years; and the percentage of total body coverage before methotrexate therapy was 67.2%, and after methotrexate therapy was 5.2%. Sixty-one percent of patients (118 patients) had complete clearing of psoriasis while taking methotrexate. The mean length of the follow-up studies is 16 months (range: 2 to 50 months). Subjective adverse effects of weekly oral doses of methotrexate were: nausea 31%, fatigue 7%, mouth ulcers 6%, headache 5%, hair loss 6%, vomiting 6%, and photosensitivity 5%. Methotrexate administration in a weekly oral dosage is an effective method of therapy for selected cases of psoriasis vulgaris. References 1. Gubner, R.; August, S.; and Ginsberg, V.: Effect of Aminopterin in Rheumatoid Arthritis and Psoriasis , Amer J Med Sc 220:176-182 ( (Feb) ) 1951.Crossref 2. Rees, R.B.; Bennett, J.H.; and Bostick, W.L.: Aminopterin for Psoriasis , Arch Derm 72:133-143 ( (Aug) ) 1955.Crossref 3. Rees, R.B., and Bennett, J.H.: Further Observations on Aminopterin for Psoriasis , J Invest Derm 32:61-66 ( (Jan) ) 1958. 4. Edmundson, W.F., and Guy, W.B.: Treatment of Psoriasis With Folic Acid Antagonist , Arch Derm 78:200-203 ( (Aug) ) 1958.Crossref 5. Hunter, G.A.: Use of Methotrexate in Treatment of Psoriasis , Aust J Derm 6:248-253 ( (June) ) 1962.Crossref 6. Dobes, W.L.: Use if Folic Acid Antagonists and Steroids in Treatment of Psoriasis , So Med J 56:187-192 ( (Feb) ) 1963.Crossref 7. Strakosch, E.A.: Study of Folic Acid Antagonists in Treatment of Psoriasis (Aminopterin vs Methotrexate vs Aminopterin and a Corticosteroid) , Dermatologica 126:259-267 ( (April) ) 1963.Crossref 8. Rees, R.B., and Bennett, J.H.: Methotrexate vs Aminopterin for Psoriasis , Arch Derm 83:970-976 ( (June) ) 1961.Crossref 9. van Scott, E.J.; Auerbach, R.; and Weinstein, G.: Parenteral Methotrexate in Psoriasis , Arch Derm 89:550-556 ( (April) ) 1964.Crossref 10. Auerbach, R.: Parenteral vs Oral Folic Acid Antagonists , Arch Derm 90:553-557 ( (Dec) ) 1964.Crossref 11. Roenigk, H.H., Jr.; Haserick, J.R.; and Curtis, G.H.: Methotrexate for Psoriasis: A Preliminary Report , Cleve Clin Quart 32:211-215 ( (Oct) ) 1965.Crossref 12. Callaway, J.L.; McAfee, W.C.; and Finlayson, R.G.: Management of Psoriasis Using Methotrexate Orally in a Single Weekly Dose , So Med J 59:424-461 ( (April) ) 1966.Crossref 13. Smith, J.R., and Graham, J.: Discussion of Paper by Rees et al: Methotrexate for Psoriasis , Arch Derm 95:2-11 ( (Jan) ) 1967.Crossref 14. Rees, R.B., et al: Methotrexate for Psoriasis , AMA Arch Derm 95:2-11 ( (Jan) ) 1967.Crossref 15. van Scott, E.J., and Reinertson, R.P.: Morphologic and Physiologic Effects of Chemotherapeutic Agents in Psoriasis , J Invest Derm 33:357-369, 1959.Crossref 16. Rall, D., et al: Folic Acid Antagonist: Effects on the Cell and the Patient , Ann Int Med 59:931-956 ( (Dec) ) 1963.Crossref 17. Condit, P.T.: Studies of Folic Acid Vitamins: II. Acute Toxicity of Aminopterin in Man , Cancer 13:222-228, ( (March) -April) 1960.Crossref 18. Ferguson, F.C., Jr.; Thiersch, J.B.; and Philips, F.S.: The Action of 4-Amino-N10-Methylpteroylglutamic Acid in Mice, Rats, and Dogs , J Pharm Exp Ther 98:293-299 ( (March) ) 1950. 19. Freeman, M.V.: The Fluorometric Measurement of the Absorption, Distribution, and Excretion of Single Doses of 4-Amino-10 Methylpteroylglutamic Acid (Amethopterin) in Man , J Pharm Exp Ther 122:154-162 ( (Jan) ) 1958. 20. Freeman, M.V.: " The Pharmacology of Methotrexate '' in Porter, R., and Witshaw, E.(eds.): Methotrexate in the Treatment of Cancer , Baltimore: The Williams & Wilkins Co. 1962, pp 17-28. 21. Henderson, E.S., and Denham, C.: The Fate of Methotrexate H3 in Rodents and Man , Proc Amer Assoc Cancer Res 4:27 ( (Jan) ) 1963. 22. Greenspan, E.M.; Goldin, A. and Schoenbach, E.B.: Studies on Mechanism of Action of Chemotherapeutic Agents in Cancer: II. Requirements for Prevention of Aminopterin Toxicity of Folic Acid in Mice , Cancer 3:856-863 ( (Sept) ) 1950.Crossref 23. Goldin, A.: Employment of Methods of Inhibition Analysis in Normal and Tumor-Bearing Mammalian Organisms , Adv Cancer Res 4:113-148 ( (Feb) ) 1956. 24. Condit, P.T.: Studies on Folic Acid Vitamins: III. Duration of Effects of Folic Acid Antagonists in Man , Cancer 13:229-235 ( (March) -April) 1960.Crossref 25. Colsky, J.; Greenspan, E.M. and Warren, T.M.: Hepatic Fibrosis in Children With Acute Leukemia After Therapy, With Folic Acid Antagonists , Arch Path 59:198-206 ( (Feb) ) 1955. 26. O'Rourke, R.A., and Eckert, G.E.: Methotrexate Induced Hepatic Injury in Adults , Arch Int Med 113:191-194 ( (Feb) ) 1964.Crossref 27. Black, R.L. et al.: Methotrexate Therapy in Psoriatric Arthritis; Double-Blind Study on 21 Patients , JAMA 819:747-754 ( (Sept) ) 1964. 28. Rees, R.B., et al: Aminopterin for Psoriasis, With Folic Acid Antagonists , Brit J Derm 55:555-564 ( (Dec) ) 1964. 29. Rees, R.B., et al: Aminopterin for Psoriasis , AMA Arch Derm 90:544-552 ( (Dec) ) 1964.Crossref 30. Shrank, A.B., and Blendis, L.M.: Folic Acid Antagonists in Treatment of Psoriasis , Brit Med J 2:156 ( (July 17) ) 1965.Crossref 31. Haim, S., and Alroy, A.: Methotrexate in Psoriasis , Lancet 1:1165 ( (May) ) 1967.Crossref 32. Ryan, T.J.; Boddington, M.M.; and Springs, A.I.: Chromosomal Abnormalities Produced by Folic Acid Antagonists , Brit J Derm 77:541-555 ( (Nov) ) 1965.Crossref 33. Hunter, G.A., and Turner, A.N.: Methotrexate in the Treatment of Psoriasis: A Controlled Clinical Trial , Aust J Derm 7:91-92 ( (Dec) ) 1963.Crossref 34. Clendenning, W., and Auerbach, R.: Keratoacanthoma in Generalized Pustular Psoriasis , Acta Dermato-Venereologica 43:68-75 ( (Jan) ) 1963. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Methotrexate for Psoriasis in Weekly Oral Doses

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References (41)

Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1969.01610190092018
Publisher site
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Abstract

Abstract A clinical evaluation is presented of 204 severe psoriatic patients treated with methotrexate, 25 mg (ten tablets) orally at weekly intervals. Preliminary evaluation of hepatic and renal function is mandatory. The mean age of patients was 44 years; mean duration of psoriasis before methotrexate therapy was 10 years; and the percentage of total body coverage before methotrexate therapy was 67.2%, and after methotrexate therapy was 5.2%. Sixty-one percent of patients (118 patients) had complete clearing of psoriasis while taking methotrexate. The mean length of the follow-up studies is 16 months (range: 2 to 50 months). Subjective adverse effects of weekly oral doses of methotrexate were: nausea 31%, fatigue 7%, mouth ulcers 6%, headache 5%, hair loss 6%, vomiting 6%, and photosensitivity 5%. Methotrexate administration in a weekly oral dosage is an effective method of therapy for selected cases of psoriasis vulgaris. References 1. Gubner, R.; August, S.; and Ginsberg, V.: Effect of Aminopterin in Rheumatoid Arthritis and Psoriasis , Amer J Med Sc 220:176-182 ( (Feb) ) 1951.Crossref 2. Rees, R.B.; Bennett, J.H.; and Bostick, W.L.: Aminopterin for Psoriasis , Arch Derm 72:133-143 ( (Aug) ) 1955.Crossref 3. Rees, R.B., and Bennett, J.H.: Further Observations on Aminopterin for Psoriasis , J Invest Derm 32:61-66 ( (Jan) ) 1958. 4. Edmundson, W.F., and Guy, W.B.: Treatment of Psoriasis With Folic Acid Antagonist , Arch Derm 78:200-203 ( (Aug) ) 1958.Crossref 5. Hunter, G.A.: Use of Methotrexate in Treatment of Psoriasis , Aust J Derm 6:248-253 ( (June) ) 1962.Crossref 6. Dobes, W.L.: Use if Folic Acid Antagonists and Steroids in Treatment of Psoriasis , So Med J 56:187-192 ( (Feb) ) 1963.Crossref 7. Strakosch, E.A.: Study of Folic Acid Antagonists in Treatment of Psoriasis (Aminopterin vs Methotrexate vs Aminopterin and a Corticosteroid) , Dermatologica 126:259-267 ( (April) ) 1963.Crossref 8. Rees, R.B., and Bennett, J.H.: Methotrexate vs Aminopterin for Psoriasis , Arch Derm 83:970-976 ( (June) ) 1961.Crossref 9. van Scott, E.J.; Auerbach, R.; and Weinstein, G.: Parenteral Methotrexate in Psoriasis , Arch Derm 89:550-556 ( (April) ) 1964.Crossref 10. Auerbach, R.: Parenteral vs Oral Folic Acid Antagonists , Arch Derm 90:553-557 ( (Dec) ) 1964.Crossref 11. Roenigk, H.H., Jr.; Haserick, J.R.; and Curtis, G.H.: Methotrexate for Psoriasis: A Preliminary Report , Cleve Clin Quart 32:211-215 ( (Oct) ) 1965.Crossref 12. Callaway, J.L.; McAfee, W.C.; and Finlayson, R.G.: Management of Psoriasis Using Methotrexate Orally in a Single Weekly Dose , So Med J 59:424-461 ( (April) ) 1966.Crossref 13. Smith, J.R., and Graham, J.: Discussion of Paper by Rees et al: Methotrexate for Psoriasis , Arch Derm 95:2-11 ( (Jan) ) 1967.Crossref 14. Rees, R.B., et al: Methotrexate for Psoriasis , AMA Arch Derm 95:2-11 ( (Jan) ) 1967.Crossref 15. van Scott, E.J., and Reinertson, R.P.: Morphologic and Physiologic Effects of Chemotherapeutic Agents in Psoriasis , J Invest Derm 33:357-369, 1959.Crossref 16. Rall, D., et al: Folic Acid Antagonist: Effects on the Cell and the Patient , Ann Int Med 59:931-956 ( (Dec) ) 1963.Crossref 17. Condit, P.T.: Studies of Folic Acid Vitamins: II. Acute Toxicity of Aminopterin in Man , Cancer 13:222-228, ( (March) -April) 1960.Crossref 18. Ferguson, F.C., Jr.; Thiersch, J.B.; and Philips, F.S.: The Action of 4-Amino-N10-Methylpteroylglutamic Acid in Mice, Rats, and Dogs , J Pharm Exp Ther 98:293-299 ( (March) ) 1950. 19. Freeman, M.V.: The Fluorometric Measurement of the Absorption, Distribution, and Excretion of Single Doses of 4-Amino-10 Methylpteroylglutamic Acid (Amethopterin) in Man , J Pharm Exp Ther 122:154-162 ( (Jan) ) 1958. 20. Freeman, M.V.: " The Pharmacology of Methotrexate '' in Porter, R., and Witshaw, E.(eds.): Methotrexate in the Treatment of Cancer , Baltimore: The Williams & Wilkins Co. 1962, pp 17-28. 21. Henderson, E.S., and Denham, C.: The Fate of Methotrexate H3 in Rodents and Man , Proc Amer Assoc Cancer Res 4:27 ( (Jan) ) 1963. 22. Greenspan, E.M.; Goldin, A. and Schoenbach, E.B.: Studies on Mechanism of Action of Chemotherapeutic Agents in Cancer: II. Requirements for Prevention of Aminopterin Toxicity of Folic Acid in Mice , Cancer 3:856-863 ( (Sept) ) 1950.Crossref 23. Goldin, A.: Employment of Methods of Inhibition Analysis in Normal and Tumor-Bearing Mammalian Organisms , Adv Cancer Res 4:113-148 ( (Feb) ) 1956. 24. Condit, P.T.: Studies on Folic Acid Vitamins: III. Duration of Effects of Folic Acid Antagonists in Man , Cancer 13:229-235 ( (March) -April) 1960.Crossref 25. Colsky, J.; Greenspan, E.M. and Warren, T.M.: Hepatic Fibrosis in Children With Acute Leukemia After Therapy, With Folic Acid Antagonists , Arch Path 59:198-206 ( (Feb) ) 1955. 26. O'Rourke, R.A., and Eckert, G.E.: Methotrexate Induced Hepatic Injury in Adults , Arch Int Med 113:191-194 ( (Feb) ) 1964.Crossref 27. Black, R.L. et al.: Methotrexate Therapy in Psoriatric Arthritis; Double-Blind Study on 21 Patients , JAMA 819:747-754 ( (Sept) ) 1964. 28. Rees, R.B., et al: Aminopterin for Psoriasis, With Folic Acid Antagonists , Brit J Derm 55:555-564 ( (Dec) ) 1964. 29. Rees, R.B., et al: Aminopterin for Psoriasis , AMA Arch Derm 90:544-552 ( (Dec) ) 1964.Crossref 30. Shrank, A.B., and Blendis, L.M.: Folic Acid Antagonists in Treatment of Psoriasis , Brit Med J 2:156 ( (July 17) ) 1965.Crossref 31. Haim, S., and Alroy, A.: Methotrexate in Psoriasis , Lancet 1:1165 ( (May) ) 1967.Crossref 32. Ryan, T.J.; Boddington, M.M.; and Springs, A.I.: Chromosomal Abnormalities Produced by Folic Acid Antagonists , Brit J Derm 77:541-555 ( (Nov) ) 1965.Crossref 33. Hunter, G.A., and Turner, A.N.: Methotrexate in the Treatment of Psoriasis: A Controlled Clinical Trial , Aust J Derm 7:91-92 ( (Dec) ) 1963.Crossref 34. Clendenning, W., and Auerbach, R.: Keratoacanthoma in Generalized Pustular Psoriasis , Acta Dermato-Venereologica 43:68-75 ( (Jan) ) 1963.

Journal

Archives of DermatologyAmerican Medical Association

Published: Jan 1, 1969

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