title: [Oral methotrexate therapy: pro and con].
abstract: For the patient suffering from severe disabling psoriasis, there is now a choice of three possible therapeutic modalities: PUVA, retinoid, or cystostatics. We have had the most experience with methotrexate, as it has been used to treat psoriasis for more than 30 years. For this reason, there is also extensive experience with regard to the risk benefit ratio for this drug. Treatment with methotrexate requires normal kidney function, liver, and bone marrow function. Pregnancy is an absolute contraindication. Methotrexate is hepatotoxic. Fibrosis and cirrhosis are not uncommon when the cumulative dosage exceeds 1.5 g; methotrexate-induced liver cirrhosis is not, however, a rapidly progressing disease. Treatment with methotrexate requires regular laboratory control, and experience to date also indicates that liver biopsy specimens should be taken during treatment.
mesh_terms: D000284:Administration, Oral; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D011565:Psoriasis / Q000188:drug therapy*; D012306:Risk
chemical_list: D008727:Methotrexate
vernacular_title: Orale Methotrexattherapie: Pro und Contra.