Ann Dermatol.  2020 Oct;32(5):402-408. 10.5021/ad.2020.32.5.402.

Therapeutic Efficacy and Safety of Methotrexate in Moderate-to-Severe Atopic Dermatitis: A Retrospective Study of Korean Patients at Tertiary Referral Hospital

• Lee JH
• Yun SJ
• Lee JB
• Lee SC

• KMID: 2506992
• DOI: http://doi.org/10.5021/ad.2020.32.5.402

Abstract

Background
Methotrexate (MTX) has been prescribed to suppress atopic dermatitis (AD) symptoms and flares in moderate-to-severe cases.
Objective
The purpose of this study was to evaluate the therapeutic efficacy and safety of MTX as well as the suppressive activity of MTX to reduce flares in moderate-to-severe AD patients.
Methods
Patients with moderate-to-severe AD who were treated with MTX at the Chonnam National University Hospital were retrospectively studied.
Results
Total 102 patients (79 males, 23 females) with a median age of 22.0±10.3 years were studied. The median initial dose of MTX was 10.3±2.6 mg/week, and the MTX-weekly dose was increased by 2.5 to 5 mg at an interval of 2 to 4 weeks to a maximum dose of 17.5±2.7 mg/week. The median maintenance dose was 11.7±2.1 mg/week; the median duration of treatment with MTX was 34.0±38.8 weeks. The initial response was noted after 5.8±3.7 weeks. Of the 102 patients, 60.8% (62/102) showed successful treatment response and 39.2% (40/102) showed mild or no improvement. MTX therapy effectively suppressed the frequency of AD flares by more than 50% in 71.1% (32/45) of the patients who responded among the MTX responders group. The most common adverse events were transient liver abnormality (5.9%, 6/102) and gastrointestinal discomfort (3.9%, 4/102), but no serious adverse events occurred.
Conclusion
Our results reveal that MTX is a relatively safe drug to control moderate-to-severe AD with satisfactory therapeutic efficacy and inhibitory activity against AD flares.

Keyword

Atopic dermatitis; Flare; Methotrexate; Therapeutic efficacy