INTERRUPTION OF LONG-TERM METHOTREXATE TREATMENT IN PSORIASIS - EVALUATION OF CLINICAL COURSE AND LABORATORY PARAMETERS AFTER DISCONTINUATION AND REINTRODUCTION OF WEEKLY ORAL METHOTREXATE

The effects of interval treatment were evaluated in 10 psoriatic patie nts on long-term treatment with low-dose oral methotrexate (MTX). In a ll patients, the dosage of MTX had already been tapered off as much as possible. After interruption of MTX treatment, the clinical course an d changes in laboratory parameters were evaluated, The mean MTX-free p eriod was 17 weeks, and the mean reduction in cumulative MTX dose was 76 mg (p = 0.05). However, only 3 patients preferred interval treatmen t to a continuous schedule. During the first 3 weeks of discontinuatio n, a significant decrease in the serum transaminases was observed, ind icating a direct toxic influence of MTX on the liver parenchym. We con clude that interruption of long-term MTX treatment leads to a substant ial reduction of the cumulative MTX dose and reduces the hepatotoxic l oad of MTX, It is necessary to motivate patients on long-term MTX trea tment for regular treatment interruptions to establish a further reduc tion in their cumulative MTX dose.