Ask the Experts - Methotrexate for Psoriatic Enthesopathy
Is treatment of enthesopathy in psoriasis with methotrexate generally successful? Should a daily exercise/flexibility routine be part of the management plan for psoriatic enthesopathy?
J. Thomas Murphy, MD
We have done better using methotrexate to treat the peripheral arthritis of the reactive spondyloarthropathies than we have with the enthesopathy. At times in psoriasis, once-weekly doses approaching 25-40 mg are used. Of course, the clinician needs to be even more careful at such doses. The routine exercise program is a must. Sometimes, for muscle spasm in the back, drugs such as amitriptyline may be used at night.
Is treatment of enthesopathy in psoriasis with methotrexate generally successful? Should a daily exercise/flexibility routine be part of the management plan for psoriatic enthesopathy?
J. Thomas Murphy, MD
We have done better using methotrexate to treat the peripheral arthritis of the reactive spondyloarthropathies than we have with the enthesopathy. At times in psoriasis, once-weekly doses approaching 25-40 mg are used. Of course, the clinician needs to be even more careful at such doses. The routine exercise program is a must. Sometimes, for muscle spasm in the back, drugs such as amitriptyline may be used at night.