Topical methotrexate in dermatology: a review of the literature

Aickara, Divya; Bashyam, Arjun M.; Pichardo, Rita O; Feldman, Steven R.

doi:10.1080/09546634.2020.1770170

Cited by 22 publications

(22 citation statements)

References 52 publications

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“…IFN seems to be efficient not only as a systemic but also as a topical [20]. Topical MTX also turned out to be efficient in early-stage MF, indicating that systemic drugs may represent new therapeutic options for topical treatment [21,22]. Concerning systemic MTX, our trial showed that RR was much higher (82%) than reported in other trials with low-dose MTX, ranging from 33 to 58% [8,14,19,23].…”

Section: Discussionmentioning

confidence: 71%

Efficacy, quality of life, and safety of methotrexate versus interferon in head-to-head treatment in advanced stages of mycosis fungoides and Sezary syndrome. Prospective trial (NCT02323659)

Chmielowska¹,

Sokołowska‐Wojdyło²,

Olszewska³

et al. 2021

pdia

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Introduction: ESMO guidelines recommend interferon (IFN) and methotrexate (MTX) as first-line systemic therapies in mycosis fungoides (MF) and Sezary syndrome (SS). Aim: A prospective, head-to-head trial comparing the efficacy and safety of INF-α and MTX as first-line treatment in MF/SS patients. Material and methods: Forty-three patients were enrolled in the trial. The response to treatment and side effects were assessed. Study variables included mSWAT, DLQI, and VAS scores. Results: The response rate in stage IV including SS was significantly higher in the IFN-α group than in the MTX group (100% vs. 40%; p = 0.03, respectively). No significant differences were found in response rate in stage IIB and III between treatment groups. Patients treated with IFN-α had significantly shorter time to achieve response (TTR). Significantly fewer in the IFN-α group experienced adverse events (AE) in comparison to patients treated with MTX (81% vs. 45%; p = 0.02). There was no statistically significant difference between both groups in terms of time to progression (TTP), progression-free survival (PFS), time on treatment (ToT), and time to next treatment (TTNT). The improvement in quality of life and reduction of pruritus was comparable in both treatment groups. Conclusions: The obtained data suggest that the efficacy of IFN-α as first-line treatment in advanced stage (IV) MF and SS is significantly better than MTX. IFN-α presented significantly better safety and tolerability and shorter TTR than MTX. However, the results should be interpreted with caution due to scarce study groups.

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Section: Discussionmentioning

confidence: 71%

Efficacy, quality of life, and safety of methotrexate versus interferon in head-to-head treatment in advanced stages of mycosis fungoides and Sezary syndrome. Prospective trial (NCT02323659)

Chmielowska¹,

Sokołowska‐Wojdyło²,

Olszewska³

et al. 2021

pdia

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“…Since then, topical methotrexate has been tried in several cases of mycosis fungoides and oral precancerous lesions and in 1 case of lymphomatoid papulosis. 3 Bergstrom et al 4 reported the case of a patient who moistened a 2.5-mg tablet of methotrexate with tap water and rubbed it onto a gauze, which he then applied daily on the newly formed papules. The treated lesions regressed within 2 to 3 days, whereas the untreated ones persisted for more than 3 weeks.…”

Section: Discussionmentioning

confidence: 99%

Lymphomatoid papulosis responding to topical methotrexate

Smilga

Dahl²

2022

JAAD Case Reports

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“…Well-known toxicity signs of methotrexate include bone marrow suppression, hepatic fibrosis, cirrhosis, and both oral and gastrointestinal ulceration [ 43 , 44 ]. Topical application of methotrexate may help avoid the systemic adverse effects of oral methotrexate for psoriasis treatment [ 45 , 46 ]. Therefore, topical treatment for local inflammatory skin diseases is considered safer to use.…”

Section: Inflammatory Skin Diseasesmentioning

confidence: 99%

Strategies to Develop a Suitable Formulation for Inflammatory Skin Disease Treatment

Guo

Jee

2021

IJMS

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Skin barrier functions, environmental insults, and genetic backgrounds are intricately linked and form the basis of common inflammatory skin disorders, such as atopic dermatitis, psoriasis, and seborrheic dermatitis, which may seriously affect one’s quality of life. Topical therapy is usually the first line of management. It is believed that successful topical treatment requires pharmaceutical formulation from a sufficient dosage to exert therapeutic effects by penetrating the stratum corneum and then diffusing to the target area. However, many factors can affect this process including the physicochemical properties of the active compound, the composition of the formulation base, and the limitations and conditions of the skin barrier, especially in inflammatory skin. This article briefly reviews the available data on these issues and provides opinions on strategies to develop a suitable formulation for inflammatory skin disease treatment.

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Topical methotrexate in dermatology: a review of the literature

Cited by 22 publications

References 52 publications

Efficacy, quality of life, and safety of methotrexate versus interferon in head-to-head treatment in advanced stages of mycosis fungoides and Sezary syndrome. Prospective trial (NCT02323659)

Efficacy, quality of life, and safety of methotrexate versus interferon in head-to-head treatment in advanced stages of mycosis fungoides and Sezary syndrome. Prospective trial (NCT02323659)

Lymphomatoid papulosis responding to topical methotrexate

Strategies to Develop a Suitable Formulation for Inflammatory Skin Disease Treatment

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