Methotrexate Versus Cyclosporine in Adults with Moderate-to-Severe Atopic Dermatitis: A Phase III Randomized Noninferiority Trial

Drug survival and postdrug survival of first‐line immunosuppressive treatments for atopic dermatitis: comparison between methotrexate and cyclosporine

“…A recently published phase 3 randomized non‐inferiority study comparing MTX at 15 mg weekly and CYC at 2.5 mg/kg/day showed a rapid onset of CYC efficacy with a larger proportion of patients achieving SCORAD 50 at 8 weeks (42% vs. 8%). Increasing the dose of MTX to 25 mg weekly resulted in a similar clinical improvement to that obtained with high doses of CYC of 5 mg/kg/day at week 20 . A paediatric study of forty children suggested similar treatment responses between CYC and MTX .…”

“…Increasing the dose of MTX to 25 mg weekly resulted in a similar clinical improvement to that obtained with high doses of CYC of 5 mg/kg/day at week 20. 8 A paediatric study of forty children suggested similar treatment responses between CYC and MTX. 9 There is at present one multicentric randomized controlled trial in the United Kingdom comparing MTX and CYC among children with moderate-to-severe AD.…”

Managing atopic dermatitis with systemic therapies in adults and adolescents: An Australian/New Zealand narrative

“…27 Although generally of poor-to-moderate quality, multiple small studies of methotrexate show a 40-70% improvement in atopic dermatitis disease activity scores. [28][29][30][31][32][33] It is as effective as ciclosporin and azathioprine 31 in the short term, has longer drug survival and post-drug survival compared to ciclosporin, 33 and is generally well tolerated.…”

Generating new evidence for old medications: the TREAT trial in paediatric atopic dermatitis

“…None of these were a head‐to‐head comparison of ciclosporin and methotrexate. Since then, ciclosporin and methotrexate have been compared in two trials, one of which included children . However, as Irvine et al .…”

“…Secondly, the 12‐week time point for the primary efficacy outcome (improvement in o‐SCORAD) will likely lead to more favourable outcomes for ciclosporin, which is quicker acting. A recent RCT in adults found that methotrexate response often occurs later than this . Fortunately, this limitation is mitigated by the inclusion of later time points (up to 36 weeks) in secondary analyses.…”