Methotrexate and liver toxicity: role of surveillance liver biopsy

Article Abstract:

It may be advisable to periodically evaluate liver tissue samples in patients with psoriatic arthritis treated with methotrexate particularly for those patients at risk for liver damage. These risk factors would include having long-term hepatitis B or hepatitis C, a history of alcohol abuse, or increased blood levels of aspartate aminotransferase. It is unclear from the current scientific literature whether the toxic effects of methotrexate are different in patients with psoriasis as compared to those with psoriatic arthritis. Current recommendations for patients with psoriasis include periodic liver biopsies. However, current recommendations for patients with arthritis do not include periodic liver biopsies. Complications associated with liver biopsies are infrequent. The cost of a liver biopsy in the United States ranges between $972 and $1500.

Complications and side effects, Liver, Methotrexate, Liver biopsy, Psoriatic arthritis

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Altered leucocyte trafficking and suppressed tumour necrosis factor alpha release from peripheral blood monocytes after intra-articular glucocorticoid treatment

Article Abstract:

Glucocorticoid injection into arthritic joints suppresses white blood cell activity, which is associated with the release of inflammatory cytokines in the joint space. Researchers monitored changes in the blood in six women with rheumatoid arthritis following injections of methylprednisolone acetate into affected joints. The glucocorticoid drug was detectable in the blood for up to 96 hours after injection, and was associated with a reduction in monocytes and lymphocytes in the blood. The release of inflammatory tumor necrosis factor from monocytes was suppressed from four hours after injection until blood levels of the antiinflammatory drug fell.

Australia, Research, Physiological aspects, Corticosteroids, Adrenocortical hormones, Tumor necrosis factor, Methylprednisolone, Leukocytes, White blood cells, Pharmacokinetics

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