{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:27:53Z","timestamp":1783358873499,"version":"3.54.6"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,7,12]],"date-time":"2016-07-12T00:00:00Z","timestamp":1468281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust J Dermatology"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The Australasian Psoriasis Collaboration reviewed methotrexate (<jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content>) in the management of psoriasis in the Australian and New Zealand setting. The following comments are based on expert opinion and a literature review. Low\u2010dose <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> (&lt;\u00a00.4\u00a0mg\/kg per week) has a slow onset of action and has moderate to good efficacy, together with an acceptable safety profile. The mechanism of action is anti\u2010inflammatory, rather than immunosuppressive. For pretreatment, consider testing full blood count (<jats:styled-content style=\"fixed-case\">FBC<\/jats:styled-content>), liver and renal function, non\u2010fasting lipids, hepatitis serology, HbA1c and glucose. Body mass index and abdominal circumference should also be measured. Optional investigations in at\u2010risk groups include an <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> test, a Quanti<jats:styled-content style=\"fixed-case\">FERON<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> Gold test and a chest X\u2010ray. In patients without complications, repeat the <jats:styled-content style=\"fixed-case\">FBC<\/jats:styled-content> at 2\u20134\u00a0weeks, then every 3\u20136\u00a0months and the liver\/renal function test at 3\u00a0months and then every 6\u00a0months. There is little evidence that a <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> test dose is of value. Low\u2010dose <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> rarely causes clinically significant hepatotoxicity in psoriasis. Most treatment\u2010emergent liver toxicity is related to underlying metabolic syndrome and non\u2010alcoholic fatty liver disease or non\u2010alcoholic steatohepatitis. Alcohol itself is not contraindicated, but should be limited to &lt;\u00a020 gm\/day. [Correction added on 6 January 2017, after first online publication: \u201820 mg\/day\u2019 has been corrected to \u201820 gm\/day\u2019.] Although <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> is a potential teratogen post\u2010conception, there is little evidence for this pre\u2010conception. <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> does not affect the quality of sperm. There is no evidence that <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> reduces healing, so there is no specific need to stop <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> peri\u2010surgery. <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> may be used in combination with cyclosporine, acitretin, prednisone and anti\u2010tumour necrosis factor biologics.<\/jats:p>","DOI":"10.1111\/ajd.12521","type":"journal-article","created":{"date-parts":[[2016,7,12]],"date-time":"2016-07-12T05:06:48Z","timestamp":1468300008000},"page":"166-170","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The Australasian Psoriasis Collaboration view on methotrexate for psoriasis in the Australasian setting"],"prefix":"10.1111","volume":"58","author":[{"given":"Marius","family":"Rademaker","sequence":"first","affiliation":[{"name":"Department of Dermatology Waikato Clinical Campus Auckland Medical School Hamilton New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monisha","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Dermatology Liverpool Hospital Liverpool New South Wales Australia"},{"name":"Department of Medicine UNSW Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Andrews","sequence":"additional","affiliation":[{"name":"Dermatology Specialist Connect Woolloongabba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Armour","sequence":"additional","affiliation":[{"name":"Department of Dermatology The\u00a0Alfred Hospital Melbourne Victoria Australia"},{"name":"Skin and Cancer Foundation Inc Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Baker","sequence":"additional","affiliation":[{"name":"Skin and Cancer Foundation Inc Melbourne Victoria Australia"},{"name":"Department of Medicine (Dermatology) The University of\u00a0Melbourne Melbourne Victoria Australia"},{"name":"Department of Dermatology St Vincent's Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Foley","sequence":"additional","affiliation":[{"name":"Skin and Cancer Foundation Inc Melbourne Victoria Australia"},{"name":"Department of Medicine (Dermatology) The University of\u00a0Melbourne Melbourne Victoria Australia"},{"name":"Department of Dermatology St Vincent's Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Gebauer","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Western Australia Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"George","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Sydney Sydney New South Wales Australia"},{"name":"Department of Medicine Storr Liver Centre Westmead Institute for Medical Research Westmead Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Rubel","sequence":"additional","affiliation":[{"name":"Department of Dermatology Canberra Hospital Canberra Australian Capital Territory Australia"},{"name":"Department of Dermatology Australian National University Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Medicine UNSW Sydney New South Wales Australia"},{"name":"Dermatology Holdsworth House Medical Practice Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,12]]},"reference":[{"key":"e_1_2_18_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2007.11.006"},{"key":"e_1_2_18_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.11.906"},{"issue":"61","key":"e_1_2_18_4_1","first-page":"S21","article-title":"How does methotrexate suppress inflammation?","volume":"28","author":"Cronstein B","year":"2010","journal-title":"Clin. 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