Methotrexate

Callen, Jeffrey P.; Kulp‐Shorten, Carol L.

doi:10.1016/b978-0-323-61211-1.00014-0

Cited by 5 publications

(4 citation statements)

References 158 publications

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“…Intermediate TPMT (6.3 to 15 U/mL): Up to 1 mg/kg daily 3. High TPMT (>15.1 to 26.4 U/mL): Up to 2–3 mg/kg daily Methotrexate (MTX) 49 Inhibits dihydrofolate reductase (DHFR) resulting in decreased DNA and RNA synthesis and proliferation of lymphocytes Doses should be administered weekly in a single weekly dose or three divided doses over a 24-hour period. Initiate with a dose of 0.3–0.5 mg/kg.…”

Section: Systemic Therapymentioning

confidence: 99%

“…This interferes with DNA and RNA synthesis, as well as the proliferation of lymphocytes. 49 It is indicated in the treatment of neoplastic diseases such as gestational choriocarcinoma, breast cancer, lung cancer, and non-Hodgkin lymphomas. It is also indicated in the symptomatic control of psoriasis that is not responsive to other forms of therapy, active rheumatoid arthritis, and polyarticular-course juvenile rheumatoid arthritis that is not responsive to first-line therapy.…”

Section: Systemic Therapymentioning

confidence: 99%

“…50 MTX may be used as an off-label treatment for recalcitrant childhood and adult AD. 49 An open-label, dose-ranging, prospective trial of 12 adults with moderate to severe AD treated with MTX for 24 weeks demonstrated an improvement in disease activity of 52% from baseline, with the majority of improvement observed by week 12. 51 A single-blind RCT of 42 adults with severe AD comparing treatment with MTX versus AZA and showed a mean SCORAD reduction of 42% in the MTX arm and a reduction of 39% in the AZA arm after 12 weeks.…”

Section: Systemic Therapymentioning

confidence: 99%

See 2 more Smart Citations

Current Perspectives on the Systemic Management of Atopic Dermatitis

Davari¹,

Nieman²,

McShane³

et al. 2021

JAA

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Atopic dermatitis (AD) is a common disease of childhood, and some patients experience a prolonged clinical course into adolescence and adulthood. Systemic management is required when AD is not adequately controlled with topical medications. Our aim is to provide a comprehensive review of commonly used systemic immunomodulating agents in childhood and adult AD, including cyclosporine A (CsA), azathioprine (AZA), methotrexate (MTX) and mycophenolate mofetil (MMF), which are prescribed off-label in the United States, as well as dupilumab, an FDA-approved biologic. We will also provide a brief overview of emerging systemic therapies currently under investigation.

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Section: Systemic Therapymentioning

confidence: 99%

Section: Systemic Therapymentioning

confidence: 99%

Section: Systemic Therapymentioning

confidence: 99%

See 1 more Smart Citation

Current Perspectives on the Systemic Management of Atopic Dermatitis

Davari¹,

Nieman²,

McShane³

et al. 2021

JAA

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“…[ 3 ] As per Roenigk et al ., methotrexate is commonly indicated in case of extensive, severe plaque psoriasis: not responsive to conventional therapy (usually >20% surface involvement). [ 4 ] We have included patients with >20% BSA involvement in our study.…”

Section: Introductionmentioning

confidence: 99%

Comparative Effectiveness and Safety of Methotrexate Versus PUVA in Severe Chronic Stable Plaque Psoriasis

Banerjee

Das

Roy

et al. 2021

Indian Journal of Dermatology

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Background: Psoriasis is a chronic, inflammatory, immune-mediated, debilitating skin disease affecting approximately 2%–3% of the global population. Various treatment modalities are available for extensive psoriasis which include methotrexate, cyclosporine, retinoids, oral PUVA therapy, and biologic agents. Aims and Objectives: The aim of this study was to compare the effectiveness and safety of methotrexate vs. PUVA in severe chronic plaque psoriasis with BSA >20%. Materials and Methods: A randomized open-label clinical study was performed. Sixty patients with extensive stable plaque psoriasis were recruited in the study. Thirty patients received methotrexate at a dose of 0.4 mg/kg up to a maximum of 15 mg/week and the rest 30 were treated by PUVA, 8-methoxy psoralen tablet (20 mg) followed by UVA started at the dose of 1 j/cm2 thrice weekly with an increment of 20% dose every third sitting until 2.5 j/cm2 is reached. Both forms of treatment were continued for 10 weeks or until PASI 90 achieved, which-ever was earlier. Clinical examination, blood investigation, PASI scoring, and photograph were repeated in serial intervals during the study. At the end of study, the data were compiled, tabulated, and analyzed. Result: In the PUVA group, 90% achieved PASI-50 and 63.33% achieved PASI-90, in the methotrexate group all patients achieved both PASI-50 and PASI-90. Methotrexate acted significantly faster than PUVA in disease clearance. In the methotrexate group decreased platelet count in 13.33% patients, decreased hemoglobin (<10 gm/dl), elevated liver enzyme, each of these developed in 10% of patients. In the PUVA group, no serious side effects were observed. Conclusions: Methotrexate is more efficacious with lesser incidence of subjective complications and more incidence of laboratory complications compared to PUVA in extensive plaque psoriasis.

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