title: Methotrexate is an effective and safe adjuvant therapy for pemphigus vulgaris.
abstract: BACKGROUND
  Pemphigus vulgaris (PV) is a chronic, autoimmune blistering disease. Most patients require long term therapy with systemic steroids as a first line of treatment. Immunosuppressive agents such as methotrexate (MTX) are administrated as second line therapy. Only a few reports have assessed MTX efficacy, with contradictory results.
  
  
  OBJECTIVE
  The aim of this study was to evaluate MTX as an adjuvant therapy in patients with PV.
  
  
  METHODS
  A retrospective study of 30 PV patients treated with MTX as an adjuvant therapy. Disease severity score and prednisone dosage served as assessing measures.
  
  
  RESULTS
  All patients were treated with 15 mg MTX per week. Of the 25 patients defined as severe or moderate disease at the beginning of treatment, 21 (84%) improved and downgraded their severity status at 6 months of treatment. In 21 patients (76.6%) we were able to reduce the prednisone dose. There was a significant improvement in the severity score (p=0.00001) and in prednisone dose (p=0.0001). Four patients (13%) suffered from mild side effects.
  
  
  CONCLUSIONS
  MTX treatment is safe and beneficial as a steroid-sparing agent in PV.
authors.affiliation: Department of Dermatology, Sheba Medical Center, 52621 Tel-Hashomer, Israel. baumdr@gmail.com
authors.forename: Sharon
authors.initials: S
authors.lastname: Baum
authors.forename: Shoshana
authors.initials: S
authors.lastname: Greenberger
authors.forename: Liat
authors.initials: L
authors.lastname: Samuelov
authors.forename: Michal
authors.initials: M
authors.lastname: Solomon
authors.forename: Anna
authors.initials: A
authors.lastname: Lyakhovitsky
authors.forename: Henri
authors.initials: H
authors.lastname: Trau
authors.forename: Aviv
authors.initials: A
authors.lastname: Barzilai
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010392:Pemphigus / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D011241:Prednisone; D008727:Methotrexate