Two Cases of Sarcoidosis Successfully Treated by Methotrexate Alone

Tanaka, Kensuke; Yamaguchi, Tetsuo; Zaima, Mika; Yamaguchi, Yoko; Isshiki, Takuma; Wakabayashi, Yoshitaka; Hosoki, Keisuke; Suzuki, Satoshi; Kono, Chiyoko; Yamada, Yoshihito; Takiguchi, Yuichi

doi:10.7878/jjsogd.30.9

Cited by 3 publications

(1 citation statement)

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“…Since the use of MTX for sarcoidosis was first reported in 1968 (17), multiple clinical trials of the drug as a steroidsparing agent have been published, especially since the 1990's (10)(11)(12)(13)(14), and several case reports have been published in Japan (18,19). Effective results of MTX treatment have been reported for lesions in the lungs (11,12), skin (11), musculoskeletal system (13) and nerves (14).…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Low-dose Methotrexate Monotherapy for Treating Sarcoidosis

et al. 2013

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Objective Methotrexate (MTX) is a cytotoxic agent that is commonly employed as an alternative to corticosteroids to treat sarcoidosis, although the proper use and efficacy of MTX as a single agent remain unclear. Methods The clinical records of patients newly diagnosed with sarcoidosis who were admitted to our institution between 2000 and 2009 were reviewed. Among these patients, 26 received 7.5 mg of MTX per week as a single agent, and the independent effects of MTX were analyzed. Results Six of the 26 patients (23%) exhibited an improvement of sarcoidosis-related lesions. The skin lesions demonstrated a relatively higher response rate (37%) than the pulmonary lesions (9%). Ten of the 26 patients (39%) experienced adverse effects, mostly mild hepatotoxicity. No severe adverse effects, including irreversible hepatotoxicity, were observed. Conclusion Although the efficacy of low-dose MTX monotherapy for sarcoidosis in this study was not high (23%), some patients exhibited definite improvements, and the drug proved to be safe, suggesting its possible benefits as a single agent for treating sarcoidosis.

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Section: Discussionmentioning

confidence: 99%

Usefulness of Low-dose Methotrexate Monotherapy for Treating Sarcoidosis

et al. 2013

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How Methotrexate is Involved in the Therapeutic Strategy of CNS Sarcoidosis ?

Ono

Ishikawa

2014

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〔総説(シンポジウム記録) 〕中枢神経サルコイドーシスとメトトレキサート中枢神経サルコイドーシス治療におけるメトトレキサートの位置づけ小野真一 1, 2) ，石川晴美 3) Shin-ichi Ono 1, 2) , Harumi Ishikawa 3) 【要旨】中枢神経サルコイドーシス(CNS sar)におけるメトトレキサート(MTX)の使用実態についてはよく分かっていない．我々は，髄膜脳炎を唯一の臨床症状とするCNS sarを経験した．プレドニゾロンの減量により症状の再燃をみたため， MTXを10 mg/週1回で5年間(累積投与量2,850 mg)併用し，症状の再燃なくプレドニゾロンを5 mg/日に減量できた．自験例を含めた報告にみる限り，CNS sarではMTXは副腎皮質ステロイドホルモン薬(以下ステロイド)と併用投与され，ステロイドが有効であればMTXも有効であった．しかし，先行投与のステロイドが無効であってもMTX有効例があり， MTXは単なる"steroid spearing effect"ではなく，何らかの相乗作用の存在が伺われる．メタボリック症候群の増加による非アルコール性脂肪性肝疾患ならびに免疫抑制薬使用によるde novo肝炎を鑑みると，今後は肝疾患に対する留意が一層重要になると考えられる．［日サ会誌 2014; 34: 35-40］キーワード：中枢神経サルコイドーシス，メトトレキサート，併用療法，肝疾患 How Methotrexate is Involved in the Therapeutic Strategy of CNS Sarcoidosis ?

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2014

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Two Cases of Sarcoidosis Successfully Treated by Methotrexate Alone

Cited by 3 publications

References 7 publications

Usefulness of Low-dose Methotrexate Monotherapy for Treating Sarcoidosis

Usefulness of Low-dose Methotrexate Monotherapy for Treating Sarcoidosis

How Methotrexate is Involved in the Therapeutic Strategy of CNS Sarcoidosis ?

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