Pongparit K, et al. - Authors sought to evaluate the efficacy of methotrexate in Asian psoriatic patients. They also identified the factors related to the clinical response of methotrexate. Compared to the clinical trials, the efficacy of methotrexate seemed to be lower in the clinical practice, but effectiveness increased with longer duration of treatment. In clinical practice problems related to methotrexate use could be due to medication adherence rather than lack of medication effectiveness. The response of methotrexate could be decreased by female sex, abdominal obesity and body mass index of 25 kg/m² or more.