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Methotrexate in steroid-dependent asthma: long-term results
R J Shiner1, I Katz, T Shulimzon
1Department of Clinical Respiratory Physiology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Allergy
|August 1, 1994
Summary
Methotrexate (MTX) effectively reduces steroid dependence in most asthma patients. This long-term study shows MTX is safe and efficacious, with manageable side effects for steroid-dependent asthma.
Area of Science:
- Pulmonology
- Immunology
- Pharmacology
Background:
- Steroid-dependent asthma requires long-term systemic corticosteroid therapy.
- Systemic corticosteroids are associated with significant side effects.
- Alternative steroid-sparing agents are needed for managing severe asthma.
Purpose of the Study:
- To evaluate the efficacy and safety of methotrexate (MTX) as a steroid-sparing agent in patients with steroid-dependent asthma.
- To assess the long-term outcomes of MTX treatment in this patient population.
Main Methods:
- Prospective evaluation of 21 steroid-dependent asthmatic patients receiving 15 mg of MTX weekly.
- Patients were followed for a mean of 14.7 months.
- Assessed changes in systemic steroid dosage, liver function, and side effects.
Main Results:
- 13 out of 21 patients were weaned off all regular systemic steroids.
- Four patients achieved a ≥50% reduction in steroid dose, and four had <50% reduction.
- Abnormal liver function tests occurred in 6 patients, resolving in 5 despite MTX continuation. Gastrointestinal side effects were reported in 6 patients, resolving in 5 with intramuscular MTX. No hematologic or pulmonary complications were observed.
Conclusions:
- Methotrexate (MTX) is a safe and effective steroid-sparing agent for most patients with steroid-dependent asthma.
- Long-term treatment with MTX can lead to significant reductions in systemic corticosteroid use.
- MTX offers a viable therapeutic option with manageable side effects for severe asthma management.