title: Low-dose methotrexate: an effective corticosteroid-sparing agent in the musculoskeletal manifestations of sarcoidosis.
abstract: Extrapulmonary sarcoidosis, and particularly the presence of musculoskeletal complications of the disease, may require chronic corticosteroid therapy. In five patients with biopsy-proven sarcoidosis and presenting recalcitrant forms of the disease, we introduced low-dose oral methotrexate (MTX) [10 mg/week (7.5-15)] for 30 months (16-34) to control the clinical and biological symptoms as well as to try to reduce the intolerated steroid posology. Beneficial effects were observed within 8-12 weeks in all patients, which allowed a reduction of 59% (35-75) of the corticosteroid posology, and maintained with a follow-up of 3 yr in 4/5 patients. No significant toxicity was observed. MTX appears to be an efficient, safe and corticosteroid-sparing therapeutic agent for the treatment of recalcitrant musculoskeletal manifestations of sarcoidosis.
authors.affiliation: Department of Rheumatology, Hospital and Faculty Xavier Bichat, University Paris VII, France.
authors.forename: O
authors.initials: O
authors.lastname: Kaye
authors.forename: E
authors.initials: E
authors.lastname: Palazzo
authors.forename: M
authors.initials: M
authors.lastname: Grossin
authors.forename: P
authors.initials: P
authors.lastname: Bourgeois
authors.forename: M F
authors.initials: MF
authors.lastname: Kahn
authors.forename: M G
authors.initials: MG
authors.lastname: Malaise
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D011859:Radiography; D012507:Sarcoidosis / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D008727:Methotrexate