Hello, Yes, though Folitrax (methotrexate) an excellent treatment option for psoriasis can cause liver toxicity on long term use. Biologicals like Adamimumab (Humira), Ustekinumab and secukinumab (scapho) are newer and excellent treatment options too which are more likely to result in complete and prolonged remissions of psoriasis. However, since these biologicals act through modification of the immune system, therefore, they can have side effects like increased susceptibility to new infections and reactivation of previous tuberculosis. Nevertheless, these newer therapies are preferred by patients and doctors alike apart from being expensive. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ivan R. Rommstein, General Surgeon