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Individual research recommendation details

Recommendation details

Recommendation ID: CG153/2
Question: Methotrexate and risk of hepatotoxicity:- What is the impact of methotrexate compared with other approaches to care (for example other systemic non-biological or biological treatments) on risk of significant liver disease in people with psoriasis and do risk factors such as obesity, alcohol use or diabetes alter this risk?
Page: 35
Any explanatory
notes (if applicable):
Why this is important:- The evidence review indicates that people with psoriasis may be at risk of liver disease, and there is great uncertainty about the contributing role of methotrexate. Clinician and patient concerns about this side effect are a common cause of treatment discontinuation. However, existing studies are poorly controlled for important confounders and many are very old. Methotrexate is a low cost intervention that is effective in an important proportion of patients. Research in this area will properly delineate the size of risk and how to minimise it. Future research should be adequately powered to detect clinically relevant liver disease, use relevant tools to do so, and properly control for relevant confounders.

Source guidance details

Comes from guidance: Psoriasis
Number: CG153
Date issued: Oct 2012

Research needed into:

Effectiveness of treatment: No
Cost of treatment: No
Implementation of treatment: No
Quality of life: No
Methods of research: No

Other details

Is this a recommendation for the use of a technology only in the context of research?: No
Is it a recommendation that suggests collection of data or the establishment of a register?: No
Recommendation priority: Unrated
Recommendation status: Research Pending
Notes: 0
Date this record updated: 30-10-2012

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This page was last updated: 20 March 2014

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.