[Methotrexate may be a useful corticosteroid reducing treatment of severe asthma]

Asthma is a chronic airway disease affecting many people worldwide. Less than 1% suffers from difficult-to-treat asthma and requires systemic corticosteroid treatment to achieve symptom control. The therapeutic options for these patients are limited and often we have to accept a lesser degree of symptom control. Methotrexate has been evaluated in 13 studies, where the mean corticosteroid dose reduction was 35%. Despite the adverse effects, we find that methotrexate may be a useful treatment of severe asthma in certain patients under close observation.