Low-dose methotrexate: an effective corticosteroid-sparing agent in the musculoskeletal manifestations of sarcoidosis.
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.
Kaye
O
O
Department of Rheumatology, Hospital and Faculty Xavier Bichat, University Paris VII, France.
Palazzo
E
E
Grossin
M
M
Bourgeois
P
P
Kahn
M F
MF
Malaise
M G
MG
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
D000305:Adrenal Cortex Hormones; D008727:Methotrexate