Methotrexate as a Single Agent for Treating Pulmonary Sarcoidosis: A Single Centre Real-Life Prospective Study

Goljan-Geremek, Anna; Bednarek, Michał; Franczuk, Monika; Puścińska, Elżbieta; Nowiński, Adam; Czystowska, Monika; Kamiński, D; Korzybski, Damian; Stokłosa, Anna; Kowalska, Anna; Wojda, Emil; Śliwiński, Paweł; Burakowska, Barbara; Ptak, Jakub; Barańska, Inga; Drygalska, Alicja; Małek, Grzegorz; Bestry, Iwona; Wesołowski, S; Kram, Marek; Górecka, Dorota

doi:10.5603/piap.2014.0069

Cited by 21 publications

(12 citation statements)

References 33 publications

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“…These data are supported by multiple case series and retrospective studies, both in pulmonary and extrapulmonary sarcoidosis (19). A dosage of 7.5 mg to 15 mg per week appears to be effective for most cases, with an overall response rate up to 55%, which may be higher if used in combination with corticosteroids and lower if used as monotherapy (19,41). However, a significant percentage of patients both in sarcoidosis and rheumatoid arthritis do not respond or have toxicity to methotrexate, which may be reflective of certain pharmacogenomic profiles or genetic predisposition to drug efficacy and/or toxicity (42,43).…”

Section: Corticosteroid-sparing Medicationsmentioning

confidence: 77%

Treatment of Sarcoidosis: A Multidisciplinary Approach

Gerke

2020

Front. Immunol.

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Sarcoidosis is a systemic disease of unknown etiology defined by the presence of noncaseating granulomatous inflammation that can cause organ damage and diminished quality of life. Treatment is indicated to protect organ function and decrease symptomatic burden. Current treatment options focus on interruption of granuloma formation and propagation. Clinical trials guiding evidence for treatment are lacking due to the rarity of disease, heterogeneous clinical course, and lack of prognostic biomarkers, all of which contribute to difficulty in clinical trial design and implementation. In this review, a multidisciplinary treatment approach is summarized, addressing immunuosuppressive drugs, managing complications of chronic granulomatous inflammation, and assessing treatment toxicity. Discovery of new therapies will depend on research into pathogenesis of antigen presentation and granulomatous inflammation. Future treatment approaches may also include personalized decisions based on pharmacogenomics and sarcoidosis phenotype, as well as patient-centered approaches to manage immunosuppression, symptom control, and treatment of comorbid conditions.

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Section: Corticosteroid-sparing Medicationsmentioning

confidence: 77%

Treatment of Sarcoidosis: A Multidisciplinary Approach

Gerke

2020

Front. Immunol.

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“…MTX has been also used successfully in the treatment of sarcoidosis as an alternative to corticosteroids [68,114,115]. Based on clinical trials, MTX is recommended as a first-line drug for patients with contraindication to corticosteroids because of toxicity or lack of efficiency [116].…”

Section: Methotrexate-based Therapy Of Other Diseasesmentioning

confidence: 99%

Overview of Dual-Acting Drug Methotrexate in Different Neurological Diseases, Autoimmune Pathologies and Cancers

Koźmiński

Halik

Chesori

et al. 2020

IJMS

222

120

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Methotrexate, a structural analogue of folic acid, is one of the most effective and extensively used drugs for treating many kinds of cancer or severe and resistant forms of autoimmune diseases. In this paper, we take an overview of the present state of knowledge with regards to complex mechanisms of methotrexate action and its applications as immunosuppressive drug or chemotherapeutic agent in oncological combination therapy. In addition, the issue of the potential benefits of methotrexate in the development of neurological disorders in Alzheimer’s disease or myasthenia gravis will be discussed.

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“…Its use in patients with granulomatosis polyangiitis [46] and sarcoidosis [47] has not been associated with any reports of de novo fILD development. In pulmonary sarcoidosis MTX monotherapy has in fact been shown to improve lung function [48].…”

Section: Discussionmentioning

confidence: 99%

Does methotrexate cause progressive fibrotic interstitial lung disease? A systematic review

et al. 2021

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The aim is to evaluate the published evidence on whether methotrexate (MTX) use causes progressive fibrotic interstitial lung disease (fILD). This PRISMA-compliant systematic review has been registered electronically with PROSPERO 2018 ID CRD42018087838, Centre of review and dissemination at the University of York. A total of 29 articles met the inclusion criteria. Thirteen articles were found to support the claim that MTX causes fILD. They all had a low Downs and Black quality score (< 6/27). Their ‘risk of bias’ assessment scores indicated serious to critical risk of bias. The 16 articles rejecting the claim that MTX causes fILD were of higher quality as indicated by their Downs and Black score. Their ‘risk of bias’ assessment scores suggested only a low to moderate risk of bias. This systematic literature review supports the finding that MTX does not cause fILD in humans. Three studies suggest that MTX treatment may actually improve outcomes in patients with rheumatoid arthritis (RA) associated fILD by slowing down ILD progression.

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Methotrexate as a Single Agent for Treating Pulmonary Sarcoidosis: A Single Centre Real-Life Prospective Study

Cited by 21 publications

References 33 publications

Treatment of Sarcoidosis: A Multidisciplinary Approach

Treatment of Sarcoidosis: A Multidisciplinary Approach

Overview of Dual-Acting Drug Methotrexate in Different Neurological Diseases, Autoimmune Pathologies and Cancers

Does methotrexate cause progressive fibrotic interstitial lung disease? A systematic review

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