Methorexate drug survival rate is low in psoriasis patients

[Turnedlight]

Just to chime in, a bit late to the game, I think....

if you have the MTHFR genetic polymorphism, you should NEVER take methotrexate. An estimated 30-60% of the population has this folate absorption/methylation disorder and many do not even know it. There's a strong intersection between autoimmune disease and MTHFR. I recently had the test done and found that I was positive for the condition and that it explains a lot of my health issues. If you have the means, do it!

Those with MTHFR have varying degrees of problems metabolizing folate. Methotrexate works by interfering with the body's use of folate (or, as you might know it, folic acid - the synthetic, cheaper, more popular version of FOLATE) a nutrient needed for cell growth. This causes problems, as you might imagine! We need ALL the B vitamins to live.

Methotrexate can cause serious issues, or simply fail to be effective (on the less extreme side), especially in those with the MTHFR C677T polymorphism. There is increased risk of MTX-induced hepatic and gastrointestinal toxicities and increased risk of severe mucositis and hematological toxicity. According to one paper I read on the topic, the MTHFR A1298C polymorphism was *not significantly associated with hepatic and hematological toxicity, however, the MTHFR C677T polymorphism is correlated with MTX toxicity via blood and other types of cancers.

There are some great websites that discuss this genetic issue and many articles from studies done on the effects of MTX/MTHFR.

Moxie

I presume that’s why you always take folic acid alongside mtx?

We do not get that kind of diagnostic test as standard but if it was that dangerous for a certain portion of the population to take mtx, I imagine they just wouldn’t risk it.

As it is on the NHS, we try things out, if they work and we’re happy then all good, if they don’t work or we have side effects, we move on. I imagine this approach is (currently) cheaper than gene profiling.