{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:34:45Z","timestamp":1789990485228,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2008,10,10]],"date-time":"2008-10-10T00:00:00Z","timestamp":1223596800000},"content-version":"vor","delay-in-days":2961,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2000,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p> <jats:bold>Objective<\/jats:bold>\u2002To evaluate the efficacy, safety and side\u2010effects of methotrexate (MTX) in psoriasis.<\/jats:p><jats:p> <jats:bold>Design<\/jats:bold>\u2002A 26\u2010year retrospective study.<\/jats:p><jats:p> <jats:bold>Setting<\/jats:bold>\u2002Department of Dermatology, Leipzig University, Leipzig, Germany.<\/jats:p><jats:p> <jats:bold>Patients<\/jats:bold>\u2002One hundred and fifty\u2010seven patients with extensive plaque psoriasis, erythrodermic, pustular and arthropathic forms, were treated with low\u2010dose methotrexate (15\u201320\u00a0mg maximum weekly dosage [Weinstein schedule]), the majority for long\u2010term periods. The mean cumulative dose was 3394\u00a0mg, the mean duration 237\u00a0weeks.<\/jats:p><jats:p> <jats:bold>Results<\/jats:bold>\u2002The effect of MTX treatment was good in 76%, moderate in 18% and poor in 6% of subjects; 61% experienced side\u2010effects, most frequently due to liver function abnormalities, bone marrow suppression, nausea, gastric complaints and hair loss. In 20% of cases the subjects were forced to discontinue therapy; 9% refused therapy due to physical and psychological discomfort, 2% wanted to become pregnant, 16% were lost to follow\u2010up, 6% died from multimorbidity and old age. Three subjects (2%) developed cancer of the lung, breast or cervix uteri, possibly in relation to long\u2010term MTX treatment. Altogether there were no deaths or life\u2010threatening side\u2010effects attributable to MTX treatment, and no cases of progressive liver cirrhosis apart from two extensive skin necroses due to overdosage (misunderstanding, suicidal attempt) that were treated successfully with citrovorum factor.<\/jats:p><jats:p> <jats:bold>Conclusion<\/jats:bold>\u2002Low\u2010dose MTX (&lt;15\u201320\u00a0mg\/week) is an effective therapy for extensive and severe forms of psoriasis if patients are selected carefully and monitored regularly, particularly with respect to liver and bone marrow toxicity. This helps to reduce severe side\u2010effects even during long\u2010term treatment. Drug interactions must be avoided. MTX therapy according to the guidelines is relatively safe and still has a place in the systemic treatment of psoriasis with 40\u00a0years of experience and an acceptable safety record.<\/jats:p>","DOI":"10.1046\/j.1468-3083.2000.00058.x","type":"journal-article","created":{"date-parts":[[2003,3,12]],"date-time":"2003-03-12T04:38:59Z","timestamp":1047443939000},"page":"382-388","source":"Crossref","is-referenced-by-count":132,"title":["Methotrexate in psoriasis: 26 years\u2019 experience with low\u2010dose long\u2010term treatment"],"prefix":"10.1111","volume":"14","author":[{"given":"U\u2010F.","family":"Haustein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Rytter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,10,10]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-195102000-00009"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1958.01560080060010"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1972.01620060005001"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(88)80237-8"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12612745"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004030050298"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI116884"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1971.04000130035004"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.1989.tb01588.x"},{"key":"e_1_2_6_11_2","first-page":"81","article-title":"Methotrexat\u2010 Blutspiegel nach oraler und intraven\u00f6ser Applikation","volume":"178","author":"Walther T","year":"1992","journal-title":"Dermatol Monschr"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1996.tb03827.x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(93)70067-4"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(93)70069-6"},{"key":"e_1_2_6_15_2","first-page":"833","article-title":"Methotrexate: bioavailability and pharmacokinetics","volume":"69","author":"Campbell MA","year":"1985","journal-title":"Cancer Treat Rep"},{"key":"e_1_2_6_16_2","first-page":"204","volume-title":"Retinoids 10 Years on","author":"Gollnick H.","year":"1991"},{"key":"e_1_2_6_17_2","first-page":"55","article-title":"Grossfl\u00e4chige erosiv\u2010h\u00e4morrhagische L\u00e4sionen in psoriatischen Plaques infolge Methotrexatin toxikation","volume":"175","author":"Rytter M","year":"1989","journal-title":"Dermatol Monatsschr"},{"issue":"12","key":"e_1_2_6_18_2","first-page":"15","article-title":"Drug interactions with methotrexate","volume":"12","author":"Evans WE","year":"1985","journal-title":"J Rheumatol"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(91)90326-J"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(98)70508-0"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12284073"},{"key":"e_1_2_6_22_2","first-page":"62","article-title":"Langj\u00e4hrige Erfahrungen mit der Methotrexatbehandlung von komplizierten Formen der Psoriasis","volume":"27","author":"Haustein UF","year":"1986","journal-title":"Medicamentum"},{"key":"e_1_2_6_23_2","first-page":"286","article-title":"Methotrexat in der Dermatologie \u2013 Klinischer Erfahrungsbericht \u00fcber 25 Jahre","volume":"6","author":"Haustein UF","year":"1994","journal-title":"Hautnah Derm"},{"key":"e_1_2_6_24_2","first-page":"235","volume-title":"Psoriasis: Proceedings of the Second International Symposium","author":"Baker H.","year":"1976"},{"key":"e_1_2_6_25_2","doi-asserted-by":"crossref","first-page":"393","DOI":"10.2340\/0001555575393396","article-title":"Interruption of long\u2010term methotrexate treatment in psoriasis. 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