[EFFECTIVENESS AND SAFETY OF METHOTREXATE MONOTHERAPY IN PATIENTS WITH PULMONARY SARCOIDOSIS]

Area of Science:

• Pulmonary Medicine
• Immunology
• Pharmacology

Background:

• Glucocorticosteroids (GCS) are standard for sarcoidosis but have contraindications and adverse reactions.
• Alternative immunosuppressants are needed for patients with GCS intolerance or resistance.
• Pulmonary sarcoidosis requires effective and safe treatment options beyond GCS.

Purpose of the Study:

• To evaluate the efficacy and safety of methotrexate monotherapy.
• To assess methotrexate as an alternative for pulmonary sarcoidosis patients with GCS contraindications or adverse reactions.

Main Methods:

• A study involving 33 patients with stage II pulmonary sarcoidosis.
• Administration of oral methotrexate (10 mg weekly).
• Regular monitoring including physical exams, chest CT, spirometry, and blood tests (hematology and chemistry).

Main Results:

• Methotrexate monotherapy demonstrated effectiveness in 72.7% of patients, achieving clinical cure or lesion regression.
• Adverse reactions were observed in 30.3% of patients.
• One patient discontinued treatment due to a serious adverse event.

Conclusions:

• Methotrexate monotherapy is a viable and effective treatment option for pulmonary sarcoidosis.
• It is particularly recommended for patients with contraindications or adverse reactions to glucocorticosteroids.
• Further research into combination therapy with methotrexate is warranted.