Long Term Methotrexate Therapy Beneficial for Juvenile Localized Scleroderma PDF Print E-mail
Wednesday, 20 February 2013 00:03
Researchers in Italy evaluated 65 patients with Juvenile Localized Scleroderma (JLS; or morphea) previously enrolled in a double blind, randomized control trial and treated for the first 3 months with oral methotrexate (MTX; 15 mg/m2 weekly) and prednisone (1 mg/kg daily, maximum 50 mg). Clinical evaluation, infrared thermography and computerized skin scores were used to evaluate lesions.

Patients were defined as responders if they satisfied criteria including no new lesions, skin score rate less than 1 and a decrease in lesion temperature by at least 10% compared with baseline. Maintaining responder status after stopping treatment for at least 6 months was classified as clinical remission (CR), and response maintained while taking MTX for at least 6 months defined CR on medication (CRM).

Fifty-eight patients (mean age, 9.4 years; 72.4% female) were followed up during a mean of 40.3 months; seven were lost to follow-up. Forty-eight patients were responders at the last follow-up, while 10 patients relapsed within 24 months of MTX initiation. Responders were evaluated every 3 to 4 months during a mean of 43 months. Thirty-five responders received MTX for a mean of 27.5 months and then maintained CR for 25.6 months or longer without MTX. Thirteen other responders were in CRM. Twenty-eight patients experienced mild MTX-related side effects, including nausea and headache, but maintained treatment.

Researchers cited difficulty in comparing data to previous studies because objective measures such as infrared thermography and computerized skin score were unavailable.

“Long-term maintenance MTX treatment is beneficial for localized scleroderma (morphea) in young patients and is generally well tolerated with rare occurrence of significant adverse events,” the researchers concluded. “We recommend an initial 3 months of combined MTX-corticosteroid therapy and MTX treatment duration of at least 24 months to ensure a prolonged and sustained disease remission for the majority of the patients.”

Source: Healio Dermatology (2013), "Long-term methotrexate therapy effectively treated juvenile localized scleroderma"; Original article can be viewed here.

 
More articles :

» Basal Activation of Type I Interferons (Alpha2 and Beta) and 2'5'OAS Genes

Danilo Bretas de Oliveira, Gabriel Magno de Freitas Almeida, Antonio Carlos Martins Guedes, Flavia Patrıcia Sena Teixeira Santos, Claudio Antonio Bonjardim, Paulo Cesar Peregrino Ferreira, and Erna Geessien KroonReceived 15 June 2011; Revised 10...

» The American College of Rheumatology Issues Guidelines for Management of Lupus Nephritis

The American College of Rheumatology (ACR) has issued newly created guidelines for the screening, treatment, and management of lupus nephritis—a severe manifestation of systemic lupus erythematosus (SLE) where the disease attacks the kidneys....

» Quality Indicator Set for Systemic Sclerosis

D. Khanna, O. Kowal-Bielecka, P.P. Khanna, A. Lapinska, S.M. Asch, N. Wenger, K.K. Brown, P. Clements, T. Getzug, M.D. Mayes, T.A. Medsger Jr., R. Oudiz, R. Simms, V. Steen, P. Maranian, D.E. FurstBackground:Systemic sclerosis (SSc) is associated...

» Orphan Drug Status Granted For Revimmune In Treatment of Systemic Sclerosis

, Inc. announced today that the U.S. Food and Drug Administration (FDA) has granted Orphan Drug Designation to RevimmuneTM, the company's proprietary system-of-care based on high-dose administration of Cytoxan(R) (), for the treatment of two...

» Methotrexate Effective In Juvenile Localized Scleroderma

is effective in when given with a short course of steroids, an Italian randomized study confirmed.Among children ages 6 to 17 receiving methotrexate, 67.4% completed the yearlong trial without flaring, compared with 29.2% of those given placebo...

» Vascular Changes in Bleomycin-Induced Scleroderma

Toshiyuki Yamamoto and Ichiro KatayamaDepartment of Dermatology, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, JapanDepartment of Dermatology, Osaka University, Yamadaoka 2-2, Suita, Osaka 565-0871, JapanReceived 6 June 2011;...

Add comment

Do feel free to leave your comments, as they would add value and knowledge to the community. However, please refrain from making any disparaging, uninformed, or unrelated comments. Thanks :)

Security code
Refresh