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Is there a down side to taking Methotrexate for my psoriatic arthritis? I've been taking it for six years. It seems to be working, but I always worry it might not be good for me.
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Methotrexate (MTX)is a drug used in treatment of cancer and autoimmune diseases such as psoriatic arthritis. It acts by inhibiting the metabolism (break down and use) of folic acid. This affects DNA synthesis and inhibits reproduction of rapidly growing cells, such as the prolific keratinocytes in psoriasis. Methotrexate also has an immunosuppressant effect, tempering the inflammatory response.
The use of Methotrexate with psoriatic arthritis hasn't been studied in depth. It appears to work well with joint symptoms from arthritis, and to a lesser extent with the skin lesions of psoriatic arthritis. As with all medications, the goal is to benefit from the positive effects of the drug with the least amount of side effects.
Possible side effects can include anemia, increased risk of bruising, nausea and vomiting, dermatitis (allergic skin reaction), and diarrhea. A small percentage of patients develop hepatitis and liver impairment. Liver biopsies have shown a tendency in psoriasis patients to have a fatty liver that may put them at risk for liver problems. Likewise, patients with psoriatic arthritis who abuse alcohol may not be good candidates for the use of Methotrexate.
Anyone taking Methotrexate for a long period of time should have liver studies done to monitor for liver damage.
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