This survey looked at the use of Methotrexate for the treatment of psoriasis from 62 countries, and suggests there are significant differences concerning the doses, routes of administration and safety monitoring among clinical practices.

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Background:
Methotrexate is one the most commonly used systemic therapies for psoriasis. Despite its widespread use in psoriasis therapy, dermatologists' practice regarding the use of methotrexate has not been investigated on global scale.

Objective:
To evaluate the real life use of methotrexate for psoriasis treatment in the dermatological community worldwide.

Methods:
A questionnaire consisting of 41 questions was designed by the Psoriasis International Network (PIN). Questions focused on safety, dosing, administration, folic acid supplementation and combination therapy aspects of methotrexate use. The anonymous web-based survey was distributed to dermatologists by the national coordinators of PIN.

Results:
Between 2 April and 7 August 2012, 481 dermatologists from 63 countries completed the questionnaire. Most respondents were from European and South American countries, whereas the response rate from Central America and the Near East was lowest. The majority of responders were experienced dermatologists (86% had more than 5 years of experience in psoriasis treatment). Starting and maintenance doses of 10 mg of methotrexate or lower were reported by 67% and 42% of respondents respectively. Thirty-eight per cent of respondents stop treatment at a cumulative dose of 2 g, whereas 36% did not consider cumulative dose important in this respect. The primary mode of administration was oral, and the majority of respondents administer folic acid supplementation. Almost all respondents monitored full blood count, liver and renal function tests, whereas procollagen 3 amino terminal peptide measurement and transient elastography is used by only a minority of dermatologists. There were significant differences concerning the doses, routes of administration and safety monitoring among the clinical practices in different geographical locations.

Conclusion:
Current clinical practice of methotrexate use in psoriasis is not uniform, depends on geographical location, and is not in full agreement with clinical guidelines.

Source: onlinelibrary.wiley.com

Now that sort of survey is very worthwhile, perhaps (although I hate methotrexate) it's time that there was a further survey to see which of these countries had the most success in reducing patients psoriasis. Then perhaps have a "joined up" approach to the use of the drug worldwide.

(Fri-18-04-2014, 11:08 AM)jiml Wrote: Now that sort of survey is very worthwhile, perhaps (although I hate methotrexate) it's time that there was a further survey to see which of these countries had the most success in reducing patients psoriasis. Then perhaps have a "joined up" approach to the use of the drug worldwide.

Me to I hate Methotrexate

But I like your thinking. The sharing of information from around the world would be a huge benefit, not only to psoriasis treatments but for all treatments.

For me an experienced dermatologist who prescribes methotrexate is NOT an experienced dermatologist.
It makes no sense poisoning people.

(Fri-18-04-2014, 21:52 PM)Caroline Wrote: For me an experienced dermatologist who prescribes methotrexate is NOT an experienced dermatologist.
It makes no sense poisoning people.

It's all about the Benjamins. Let's start with the cheapest drug and who gives a care if it works. That's four years of saving until the patient liver start's to give out. That is the way it is here unless you have non government subsidized insurance.

(Sat-19-04-2014, 02:06 AM)mataribot Wrote:

(Fri-18-04-2014, 21:52 PM)Caroline Wrote: For me an experienced dermatologist who prescribes methotrexate is NOT an experienced dermatologist.
It makes no sense poisoning people.

It's all about the Benjamins. Let's start with the cheapest drug and who gives a care if it works. That's four years of saving until the patient liver start's to give out. That is the way it is here unless you have non government subsidized insurance.

You are totally right. That is also what they told me over here, it is the protocol to start with the cheapest, and in reverse this may turn out to be the most expensive route when you really turn sick.
That is not only with drugs, it is common for the current management approach in large projects like high speed trains or fighting airplanes.

Some afterthoughts.

My mum has in the mean time recovered from breast cancer. About two years ago this was discovered.
She was treated by means of chemotherapy and finally an operation with a breast reconstruction. It is not pretty, but still is better then nothing I think.

Now after almost two years the final conclusion is that though the chemotherapy was necessary, it is quite heavy for your body. One thing that is very measurable is that her heartbeat that was previously at 45 strokes/min, she has a big heart and emotionally still has that, went to about 88 right now.
So basic conclusion may be that specifically the chemo has hit her hard and that certainly also her heart was one of the organs that surely was touched, almost all chemo has flown through it.

This conclusion leads me to the afterthought that this is one of the points I have against MTX, which as most of you already know is a medication used in cancer therapy.
Basically a poison.

(Thu-12-06-2014, 19:48 PM)Caroline Wrote: My mum has in the mean time recovered from breast cancer. About two years ago this was discovered.

Wow that long, I remember you telling me. Please send her my regards.

(Thu-12-06-2014, 19:48 PM)Caroline Wrote: Basically a poison.

Hey guess what;