International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients With Psoriasis

Area of Science:

• Dermatology
• Rheumatology
• Pharmacology

Background:

• Methotrexate (MTX) is a widely used, affordable drug for psoriasis.
• Current MTX dosing regimens lack uniformity, potentially leading to suboptimal patient outcomes.
• Standardizing MTX treatment could improve psoriasis management globally.

Purpose of the Study:

• To achieve international expert consensus on a uniform methotrexate dosing regimen for adult and pediatric psoriasis patients.
• To identify areas for future research in methotrexate therapy for psoriasis.

Main Methods:

• A modified eDelphi procedure survey was conducted with 180 international psoriasis experts over three rounds.
• Consensus was defined as less than 15% disagreement in the survey and less than 30% in the consensus meeting.
• A final conference meeting addressed proposals without consensus.

Main Results:

• Consensus was reached on 20 out of 21 proposals regarding methotrexate dosing for psoriasis.
• The study involved 180 participants, with 58 attending the final consensus meeting.
• Specific areas requiring further research include folic acid supplementation and dosing for pediatric and vulnerable patient groups.

Conclusions:

• This eDelphi consensus provides a foundation for harmonizing methotrexate dosing in psoriasis treatment.
• The established consensus can guide more consistent and effective methotrexate therapy for psoriasis patients globally.
• Further research is essential to refine methotrexate protocols for specific patient subgroups.