Twelve years’ experience with methotrexate for GINA treatment step 5 asthma patients

Domingo, Christian; Moreno, Amàlia; Amengual, M. J.; Comet, R; Luján, Manel

doi:10.1185/03007990802643466

Cited by 18 publications

(16 citation statements)

References 22 publications

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“…10 The mechanism of action of MTX as an anti-inflammatory or antiangiogenic drug is not fully understood. Angiogenic factors play significant roles in the regulation of capillary and basilar membrane permeability in NPs.…”

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confidence: 99%

Effects of Methotrexate on Vascular Endothelial Growth Factor, Angiopoietin 1, and Angiopoietin 2 in Nasal Polyps

Park

Kim

Yang

et al. 2011

Am J Rhinol�Allergy

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confidence: 99%

Effects of Methotrexate on Vascular Endothelial Growth Factor, Angiopoietin 1, and Angiopoietin 2 in Nasal Polyps

Park

Kim

Yang

et al. 2011

Am J Rhinol�Allergy

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“…In the first short‐term observational study 42 we observed a mean 50% decrease in oral corticosteroids when MTX was added. Our clinical assay 7 (double‐blind placebo‐controlled) showed that MTX allowed a 54% reduction (9.5 mg/day) in the oral corticosteroid dose; finally, our 12‐year naturalistic study showed that oral corticosteroids were withdrawn in 25 out of 42 patients, and in the remaining 17 patients the dose was notably reduced, by around 60% 56 . Corrigan et al 57 .…”

Section: Drugsmentioning

confidence: 68%

Rationale for the use of immunomodulatory therapies in the Global Initiative for Asthma (GINA) step V asthma other than oral glucocorticosteroids

Domingo

Moreno

Mirapeix

2011

Internal Medicine Journal

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Asthma is a major problem worldwide, which is estimated to affect 300 million individuals. The global prevalence ranges from 1% to 18% of the population. The incidence, morbidity and mortality of the condition have increased over the last 50 years despite the development of new anti-asthmatic drugs. Fewer than 1% of the asthmatic population are steroid-dependent, but these patients consume most of the resources and time at asthma units. The consensus documents published by professional societies all support a stepwise therapeutic approach for asthma. However, patients who require frequent or continuous oral corticosteroid administration have received little attention. Due to the severe side-effects of oral corticosteroids when administered over long periods or at high doses, many drugs have been assessed in the search for a possible corticosteroid-sparing agent. Recently, the update of the Global Initiative for Asthma (GINA) introduced a new drug--omalizumab--as an alternative to oral corticosteroids in patients included in step V. Other alternatives include immunosuppressive drugs, among which methotrexate has been found to offer the best benefit/risk ratio. This paper will review, comment and criticize the evidence of the effectiveness of immunomodulatory drugs, as an alternative to oral glucocorticosteroid treatment in GINA step V asthma patients. The experience of the authors combined with the information of the literature will lead to the conclusion that methotrexate and omalizumab are the only advisable drugs and will clarify when and how these drugs should be used.

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“…When it was decided to continue OMA treatment, the OC dose was progressively reduced. In a previous study in severe asthma patients treated with methotrexate , we observed that some patients started to respond after 9–10 months of treatment . As a result, we decided to maintain the treatment with OMA for at least 12 months after classifying the patient as a responder, which gave a minimum period of 18 months before considering whether to decrease the OMA dose.…”

Section: Discussionmentioning

confidence: 99%

A step‐down protocol for omalizumab treatment in oral corticosteroid‐dependent allergic asthma patients

Domingo

Pomares

Navarro

et al. 2017

Brit J Clinical Pharma

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Twelve years’ experience with methotrexate for GINA treatment step 5 asthma patients

Cited by 18 publications

References 22 publications

Effects of Methotrexate on Vascular Endothelial Growth Factor, Angiopoietin 1, and Angiopoietin 2 in Nasal Polyps

Effects of Methotrexate on Vascular Endothelial Growth Factor, Angiopoietin 1, and Angiopoietin 2 in Nasal Polyps

Rationale for the use of immunomodulatory therapies in the Global Initiative for Asthma (GINA) step V asthma other than oral glucocorticosteroids

A step‐down protocol for omalizumab treatment in oral corticosteroid‐dependent allergic asthma patients

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