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July 8, 2026Acta Dermato VenereologicaOpen Access

A Systematic Literature Review on Methotrexate Hepatotoxicity in Psoriasis Management: Preconceived Notion or Real Threat?

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Authors

WBWolf-Henning BoehnckeMCM. ConstantinJCJosé-Manuel Carrascosa-Carrillo

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Overview

Systematic review evaluates methotrexate hepatotoxicity in psoriasis, suggesting risks and monitoring strategies.

Key Points

  • To assess the association between methotrexate and hepatotoxicity in psoriasis management and identify risk factors and monitoring strategies.
  • Systematic literature review from 2003 to 2024 including studies from MEDLINE/PubMed, EMBASE, Cochrane Library, and grey literature.
  • Evaluation of English and French studies on human subjects covering guidelines, reviews, and observational/interventional studies.
  • Analysis of risk factors such as obesity, diabetes, and alcohol use in relation to MTX use.
  • Methotrexate-associated hepatotoxicity is multifactorial with specific risk factors identified.
  • Inconsistent monitoring of liver function tests reported, highlighting a need for standardized protocols.
  • Folic acid supplementation may reduce risk but appropriate dosing is not consistently established.

Cite This Study

Boehncke et al. (2026) studied this question.

synapsesocial.com/papers/6a4deabbd2ea289ef6284369https://doi.org/10.2340/actadv.v106.adv-2025-0021
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Innovative approach on monitoring methotrexate induced hepatotoxicity in psoriasis patients – A case report2025
  2. 2Methotrexate-Induced Hepatotoxicity: A Narrative Review of Mechanisms, Risk Factors, and Management Strategies2026
  3. 3Cumulative methotrexate dose is not associated with liver fibrosis in patients with a history of moderate-to-severe psoriasis2024 · 12 citations
  4. 4Effect of Methotrexate Discontinuation on Psoriatic Patients with Significant Liver Fibrosis2025
  5. 5Methotrexate Toxicity-Induced Pancytopenia and Mucocutaneous Ulcerations in Psoriasis2024 · 1 citations