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Vol. 101. Issue 7.
Pages 600-613 (September 2010)
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Vol. 101. Issue 7.
Pages 600-613 (September 2010)
Consensus statement
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Guidelines on the Use of Methotrexate in Psoriasis
Metotrexato: guía de uso en psoriasis
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G. Carreteroa,
Corresponding author
gcarrete@aedv.es

Corresponding author.
, L. Puigb, L. Dehesaa, J.M. Carrascosac, M. Riberad, M. Sánchez-Regañae, E. Daudénf, D. Vidalg, M. Alsinah, C. Muñoz-Santosh, J.L. López-Estebaranzi, J. Notarioj, C. Ferrandizc, F. Vanaclochak, M. García-Bustinduyl, R. Tabernerm, I. Belinchónn, J. Sánchez-Carazoo, J.C. Morenop, the Psoriasis Group of the Spanish Academy of Dermatology and Venereology
a Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
b Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
c Hospital Germans Trias i Pujol, Barcelona, Spain
d Hospital Universitari de Sabadell, Corporació Parc Taulí, Sabadell, Spain
e Hospital Universitario Sagrat Cor, Barcelona, Spain
f Hospital Universitario La Princesa, Madrid, Spain
g Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain
h Hospital Clínic, Barcelona, Spain
i Hospital Fundación Alcorcón, Madrid, Spain
j Hospital Universitario de Bellvitge de Hospitalet de Llobregat, Barcelona, Spain
k Hospital 12 de Octubre, Madrid, Spain
l Hospital Universitario de Canarias, Tenerife, Spain
m Hospital Son Llàtzer, Palma de Mallorca, Islas Baleares, Spain
n Hospital General de Alicante, Alicante, Spain
o Hospital General Universitario, Valencia, Spain
p Hospital Reina Sofía, Córdoba, Spain
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Abstract

Psoriasis, a chronic multifactorial inflammatory disease that develops in genetically predisposed individuals, affects approximately 1.5% of the Spanish population. This disease has a negative impact on patients’ quality of life, and long-term therapy is often required to control the symptoms. In addition to the classical systemic treatments (methotrexate, acitretin, cyclosporine, and ultraviolet light), the group of drugs known as biologics (etanercept, infliximab, adalimumab, and ustekinumab) provides the dermatologist with an expanded therapeutic armamentarium, thereby improving the likelihood of controlling psoriasis in patients with severe and/or extensive disease. Methotrexate, a classic antipsoriatic drug, is still very useful either as single-drug therapy or in combination with other systemic drugs, particularly as a rescue therapy or combined with biologics. This article aims to establish the role of methotrexate in the treatment of psoriasis. We considered it of interest to develop guidelines for using methotrexate in the management of psoriasis with a view to ensuring the safe and proper use of this drug in the management of psoriasis. This document was developed by consensus among members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology.

Keywords:
Methotrexate
Guidelines
Treatment
Psoriasis
Resumen

La psoriasis es una enfermedad inflamatoria crónica, de predisposición genética y origen multifactorial, que afecta aproximadamente al 1,5% de la población española, repercutiendo negativamente de forma importante en la calidad de vida de los pacientes, los cuales requieren frecuentemente tratamientos de larga duración, para controlar sus síntomas. Los tratamientos sistémicos clásicos (metotrexato, acitetrino, ciclosporina, luz ultravioleta), junto con las denominadas terapias biológicas (etanercept, infliximab, adalimumab, ustekinumab), permiten al dermatólogo disponer de un arsenal terapéutico más amplio y disponer, por lo tanto, de mayores posibilidades de control de pacientes con psoriasis severa y/o extensa. El metotrexato, un fármaco clásico en la terapia antipsoriásica, sigue siendo de gran utilidad tanto en monoterapia como asociado a otros fármacos sistémicos, en especial como rescate o combinación con los biológicos. El objetivo de este artículo es establecer el papel del metotrexato en el tratamiento de la psoriasis. Por ello hemos creído de interés elaborar una guía de uso de metotrexato en psoriasis, consensuada entre varios componentes del Grupo de Psoriasis de la Academia Española de Dermatología y Venereología, que facilite la utilización segura y precisa de este fármaco en el manejo de pacientes con psoriasis.

Palabras clave:
Metotrexato
Guía
Tratamiento
Psoriasis
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