Methotrexate and psoriasis: 2009 National Psoriasis Foundation Consensus Conference

Kalb, Robert E.; Strober, Bruce; Weinstein, Gerald D.; Lebwohl, Mark

doi:10.1016/j.jaad.2008.11.906

Cited by 310 publications

(374 citation statements)

References 91 publications

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“…The most frequent type is a mild psoriasis, which mainly requires topical treatment. In this context, methotrexate still has a golden role in psoriasis treatment [36][37][38][39][40].…”

Section: Introductionmentioning

confidence: 99%

Functionalized gold nanoparticles for topical delivery of methotrexate for the possible treatment of psoriasis

Bessar

Venditti

Benassi

et al. 2016

Colloids and Surfaces B: Biointerfaces

118

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a b s t r a c tGold nanoparticles (AuNPs) represent an effective choice for topical drug delivery systems thanks to their small size, general non-toxicity, ease of functionalization and high surface to volume ratio. Even if systemic, methotrexate still plays an important role in psoriasis treatment: its topical use shows insufficient percutaneus penetration owing to limited passive diffusion, high molecular weight and dissociation at physiological pH. The aim of our study was to design a new drug delivery nanocarrier for Methotrexate and to improve its solubility, stability and biodistribution. AuNPs were on purpose prepared with a hydrophilic stabilizing layer, in order to improve the colloidal stability in water. Watersoluble gold nanoparticles functionalized by sodium 3-mercapto-1-propansulfonate (Au-3MPS) were prepared and loaded with methotrexate (MTX). The loading efficiency of MTX on Au-3MPS was assessed in the range 70-80%, with a fast release (80% in one hour). The release was studied up to 24 h reaching the value of 95%. The Au-3MPS@MTX conjugate was fully characterized by spectroscopic techniques (UV-vis, FTIR) and DLS. Preliminary toxicity tests in the presence of keratinocytes monolayers allowed to assess that the used Au-3MPS are not toxic. The conjugate was then topically used on C57BL/6 mouse normal skin in order to trace the absorption behavior. STEM images clearly revealed the distribution of gold nanoparticles inside the cells. In vitro studies showed that Methotrexate conjugated with Au-3MPS is much more efficient than Methotrexate alone. Moreover, DL50, based on MTT analysis, is 20 folds reduced at 48 h, by the presence of nanoparticles conjugation. UV-vis spectra for in vivo tracing of the conjugate on bare mouse skin after 24 h of application, show increased delivery of Methotrexate in the epidermis and dermis using Au-3MPS@MTX conjugate, compared to MTX alone. Moreover we observed absence of the Au-3MPS in the dermis and in the epidermis, suggesting that these layers of the skin do not retain the nanoparticles. Based on our data, we found that the novel Au-3MPS@MTX conjugate is an effective non-toxic carrier for the satisfactory percutaneous absorption of Methotrexate and could help in possible topical treatment of psoriasis.

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“…The most frequent type is a mild psoriasis, which mainly requires topical treatment. In this context, methotrexate still has a golden role in psoriasis treatment [36][37][38][39][40].…”

Section: Introductionmentioning

confidence: 99%

Functionalized gold nanoparticles for topical delivery of methotrexate for the possible treatment of psoriasis

Bessar

Venditti

Benassi

et al. 2016

Colloids and Surfaces B: Biointerfaces

118

View full text Add to dashboard Cite

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“…Liver function is the major concern when selecting the optimal treatment in those patients. Systemic drugs such as MTX, acitretin and even biological agents are reported to cause liver test abnormalities [13][14][15] . In our clinical study, patients were treated with combination therapy of infliximab and TGP.…”

Section: Discussionmentioning

confidence: 99%

Clinical experience of combination therapy of infliximab and total glucosides of paeony for severe psoriasis with liver disorder history

Hu¹,

Lin²,

Cui³

et al. 2017

Trends Immunother

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Severe psoriasis patients are reported to have a higher risk of liver abnormalities. Treatment option for severe psoriasis patients with liver disorder history remains a great challenge. Hepatic toxicity and long-term safety are the major concerns. Hence, it is necessary to look for safer and more effective treatment for those patients. This retrospective review evaluated the safety and efficacy of combination therapy of infliximab and total glucosides of paeony (TGP) in treating 13 severe psoriasis patients with liver disorder history. Patients with severe psoriasis, comprising eight men and five women with a mean age of 37.3 ± 12.3, were observed. The patients experienced a mean course of psoriasis of 11.2 ± 7.1 years. The mean psoriasis area and severity index (PASI) score was 29.3 ± 12.9. All patients have the history of liver disorder. In our study, these patients were treated with infliximab at a dose of 5 mg/kg and TGP at a dose of 1.8 g/day. No liver test abnormalities were seen during combination therapy. After treatment, 61.5% patients showed PASI 50 response at week 2, and 81.8% patients have PASI 75 response at week 6. The mean time for achieving PASI 75 and PASI 90 improvement was 4.2 weeks and 9.6 weeks, respectively. Our observation demonstrates that combined therapy of infliximab and TGP is effective and safe in the treatment of severe psoriasis, especially for patients with liver disorder history. Keywords: psoriasis; infliximab; total glucosides of paeony; liver disorder; treatment ARTICLE INFO

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“…3 Treatment guidelines on the use of MTX in psoriasis have been published by Roenigk et al in 1973, 4 1982, 5 1998 6 and updated by a group of experts from the United States National Psoriasis Foundation in 2009. 7 Absolute or relative overdose of methotrexate can result in acute toxicity, manifested clinically by myelosuppression, mucosal ulceration (especially oral), and rarely cutaneous necrolysis. Relative overdose is seen in cases where there is interference with renal excretion of methotrexate and certain drug interactions.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of acute methotrexate toxicity manifesting as ulcers on psoriatic plaques in an elderly male

Singh¹,

Chatterjee²,

Banerjee

et al. 2015

Medical Journal Armed Forces India

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Methotrexate and psoriasis: 2009 National Psoriasis Foundation Consensus Conference

Cited by 310 publications

References 91 publications

Functionalized gold nanoparticles for topical delivery of methotrexate for the possible treatment of psoriasis

Functionalized gold nanoparticles for topical delivery of methotrexate for the possible treatment of psoriasis

Clinical experience of combination therapy of infliximab and total glucosides of paeony for severe psoriasis with liver disorder history

An unusual case of acute methotrexate toxicity manifesting as ulcers on psoriatic plaques in an elderly male

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