Low-dose oral pulse methotrexate as monotherapy in elderly patients with bullous pemphigoid

Bullous pemphigoid: a case series with emphasis on long-term remission off therapy

“…MTX was first reported as a treatment for BP in 1969 (6), and has subsequently been confirmed by multiple studies as an effective corticosteroidsparing agent (7)(8)(9)(10)(11)(12)(13). In 1994, our group showed low-dose MTX to be a safe and effective adjuvant therapy alongside oral prednisone in the treatment of elderly patients with BP (13).…”

Management of autoimmune bullous diseases: Pharmacology and therapeutics

“…155 In one patient, improvement was seen within a few days, and a 2-year remission was obtained after 3 cycles. 101 Three patients in another report had significant improvement. 153 Figure 4 is a proposed algorithm for the treatment of EBA.…”

“…152 Extracorporeal photochemotherapy has been reported to be effective in 4 cases of refractory EBA. 101,153 In one patient, it was successful within days, after 3 treatment courses that resulted in remission for more than 2 years. However, in this patient, a cardiomyopathy of unknown cause developed.…”

“…100 MTX was found to be effective in small doses (up to 12.5 mg/wk) as a sole therapy in 12 patients with BP. 101 Chlorambucil, 2 mg daily, resulted in a reduction in the amount of glucocorticoid required for the control of 23 cases of BP. 102 Cyclosporine A is used in a dose of 6 mg/kg/d (in 2 equal doses).…”

Management of Bullous Pemphigoid with Topical Steroids in the Clinical Practice of a Single Center: Outcome at 6 and 12 Months

“…Oral corticosteroids are still used when the application of topical steroid is too difficult. Immunosuppressant agents such as methotrexate or mycophenolate mofetil are prescribed in cases of resistance or dependence to steroids [11,12,13,14]. …”