title: Low-dose methotrexate therapy for childhood sarcoidosis.
abstract: OBJECTIVE
  To evaluate the effectiveness of low oral doses of methotrexate as a steroid-sparing agent in children with sarcoidosis.
  
  
  METHODS
  An open-label, noncontrolled trial. Methotrexate was administered orally at a single weekly dose of 10 to 15 mg/m2. Duration of therapy was open ended, but patients received treatment for a minimum of 6 months to be considered as having completed the study.
  
  
  RESULTS
  Seven children with biopsy-proven sarcoidosis completed the study. The mean dose of prednisone was successfully tapered from 49 mg/day (1.3 mg/kg) to 18 mg/day (0.5 mg/kg) after 3 months of methotrexate therapy and to 9.9 (0.2 mg/kg) and 7.3 mg/day (0.1 mg/kg) after 6 months and at the end of the follow-up period, respectively. Other clinical and laboratory parameters improved significantly after methotrexate therapy was started. There was significant clinical improvement, as confirmed by the reduction of the clinical severity score from 8 +/- 1.1 to 0.8 +/- 0.5 point after 3 months of methotrexate therapy, and to 0.7 and 0.5 +/- 0.3 point after 6 months and at the end of the follow-up, respectively. Laboratory measurements revealed marked improvement, as reflected by a significant reduction in the erythrocyte sedimentation rate and an increase of hemoglobin values. The mean serum angiotensin-converting enzyme activity dropped significantly. No adverse side effects were noted with methotrexate therapy.
  
  
  CONCLUSIONS
  Our study demonstrated that low-dose oral methotrexate therapy was effective and safe and had steroid-sparing properties in seven children with sarcoidosis.
authors.affiliation: Division of Pediatric Rheumatology, Children's Hospital, New Orleans, Louisiana State University Medical Center 70112-2822, USA.
authors.forename: A
authors.initials: A
authors.lastname: Gedalia
authors.forename: J F
authors.initials: JF
authors.lastname: Molina
authors.forename: G S
authors.initials: GS
authors.lastname: Ellis
authors.forename: W
authors.initials: W
authors.lastname: Galen
authors.forename: C
authors.initials: C
authors.lastname: Moore
authors.forename: L R
authors.initials: LR
authors.lastname: Espinoza
mesh_terms: D000284:Administration, Oral; D002648:Child; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D011241:Prednisone / Q000627:therapeutic use; D012507:Sarcoidosis / Q000145:classification / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D011241:Prednisone; D008727:Methotrexate