Methotrexate as an Adjuvant Treatment for Pemphigus Vulgaris

Pemphigus foliaceus

“…With an average methotrexate dose of 18.9 mg weekly, most patients were either able to stop prednisone completely (70%) or continue with a reduced average range of 2 to10 mg daily (22%). Similar results have been found in other studies [11,12]. Eventual weaning from methotrexate without a flare for those on methotrexate monotherapy was successful in 21% although the dose of methotrexate was at least reduced by one-half in 57% of patients [6].…”

Pemphigus foliaceus

“…With an average methotrexate dose of 18.9 mg weekly, most patients were either able to stop prednisone completely (70%) or continue with a reduced average range of 2 to10 mg daily (22%). Similar results have been found in other studies [11,12]. Eventual weaning from methotrexate without a flare for those on methotrexate monotherapy was successful in 21% although the dose of methotrexate was at least reduced by one-half in 57% of patients [6].…”

British Association of Dermatologists’ guidelines for the safe and effective prescribing of methotrexate for skin disease 2016

“…These showed that 66–76% of patients could be weaned off prednisolone successfully or have doses reduced within 6–18 months using MTX doses of 10–25 mg weekly. All three studies were small (maximum of 30 patients) but show consistent results . A placebo‐controlled RCT of adjuvant MTX is now warranted.…”

Guidelines

“…However, a recent study of nine patients with recalcitrant PV on CS reports favourable outcomes and few side‐effects in response to the addition of a mean dose of 12 mg of methotrexate weekly. CS were completely withdrawn within 6 months in six patients (67%) compared with an estimated 5–7% of similar patients treated previously at the same centre with CS alone 61 …”

Pemphigus foliaceus

“…With an average methotrexate dose of 18.9 mg weekly, most patients were either able to stop prednisone completely (70%) or continue with a reduced average range of 2 to10 mg daily (22%). Similar results have been found in other studies [11,12]. Eventual weaning from methotrexate without a flare for those on methotrexate monotherapy was successful in 21% although the dose of methotrexate was at least reduced by one-half in 57% of patients [6].…”

British Association of Dermatologists’ guidelines for the safe and effective prescribing of methotrexate for skin disease 2016

“…These showed that 66–76% of patients could be weaned off prednisolone successfully or have doses reduced within 6–18 months using MTX doses of 10–25 mg weekly. All three studies were small (maximum of 30 patients) but show consistent results . A placebo‐controlled RCT of adjuvant MTX is now warranted.…”

Guidelines

“…However, a recent study of nine patients with recalcitrant PV on CS reports favourable outcomes and few side‐effects in response to the addition of a mean dose of 12 mg of methotrexate weekly. CS were completely withdrawn within 6 months in six patients (67%) compared with an estimated 5–7% of similar patients treated previously at the same centre with CS alone 61 …”

Pemphigus foliaceus

“…With an average methotrexate dose of 18.9 mg weekly, most patients were either able to stop prednisone completely (70%) or continue with a reduced average range of 2 to10 mg daily (22%). Similar results have been found in other studies [11,12]. Eventual weaning from methotrexate without a flare for those on methotrexate monotherapy was successful in 21% although the dose of methotrexate was at least reduced by one-half in 57% of patients [6].…”

British Association of Dermatologists’ guidelines for the safe and effective prescribing of methotrexate for skin disease 2016

“…These showed that 66–76% of patients could be weaned off prednisolone successfully or have doses reduced within 6–18 months using MTX doses of 10–25 mg weekly. All three studies were small (maximum of 30 patients) but show consistent results . A placebo‐controlled RCT of adjuvant MTX is now warranted.…”

Guidelines

“…However, a recent study of nine patients with recalcitrant PV on CS reports favourable outcomes and few side‐effects in response to the addition of a mean dose of 12 mg of methotrexate weekly. CS were completely withdrawn within 6 months in six patients (67%) compared with an estimated 5–7% of similar patients treated previously at the same centre with CS alone 61 …”