title: Methotrexate in pediatric plaque-type psoriasis: Long-term daily clinical practice results from the Child-CAPTURE registry.
abstract: BACKGROUND
  Evidence on effectiveness and safety of methotrexate (MTX) in pediatric psoriasis is scarce.
  
  
  OBJECTIVE
  To study the effectiveness and safety of MTX in pediatric plaque-type psoriasis and its influence on quality of life (Qol) in daily clinical practice.
  
  
  METHODS
  Subset analysis of prospectively collected data extracted from the Child-CAPTURE registry, a single center, longitudinal, long-term, observational daily practice cohort of pediatric psoriasis patients. A maximum dose between 0.14 and 0.63 mg/kg once weekly was prescribed in 25 children. Primary endpoints were percentages of patients with ≥ 75% improvement in the Psoriasis Area and Severity Index (PASI) at week 12 and 24.
  
  
  RESULTS
  PASI75 was achieved in 4.3% and 33.3% of patients at week 12 and 24, whereas 40% and 28.6% reached PASI 75 at week 36 and 48. Median PASI and body surface area decreased from 10.0 (range 3.8-42.4) and 11.0 (range 3.5-72.0) at baseline to 4.3 (range 0-19.8) and 2.6 (range 0.0-39.6) at week 24, respectively. Physician Global Assessment improved significantly from 3.0 to 1.2 at week 24. A significant decrease in Children's Dermatology Life Quality Index from 9.0 to 3.8 at week 24 was found. Most reported adverse events were severe nausea (n = 5), infections requiring antibiotics (n = 5) and tiredness (n = 4).
  
  
  CONCLUSIONS
  MTX shows a positive effect on PASI scores, improves Qol and has a reasonable safety profile.
authors.affiliation: a Department of Dermatology .
authors.forename: M J
authors.initials: MJ
authors.lastname: van Geel
authors.affiliation: a Department of Dermatology .
authors.forename: A M
authors.initials: AM
authors.lastname: Oostveen
authors.affiliation: b Department of Pediatric Rheumatology , and.
authors.forename: E P A H
authors.initials: EP
authors.lastname: Hoppenreijs
authors.affiliation: c Department of Health Evidence , Radboud university medical center , Nijmegen , the Netherlands.
authors.forename: J C M
authors.initials: JC
authors.lastname: Hendriks
authors.affiliation: a Department of Dermatology .
authors.forename: P C M
authors.initials: PC
authors.lastname: van de Kerkhof
authors.affiliation: a Department of Dermatology .
authors.forename: E M G J
authors.initials: EM
authors.lastname: de Jong
authors.affiliation: a Department of Dermatology .
authors.forename: M M B
authors.initials: MM
authors.lastname: Seyger
mesh_terms: D000293:Adolescent; D000875:Anthralin / Q000627:therapeutic use; D001830:Body Surface Area; D002648:Child; D002675:Child, Preschool; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D010789:Phototherapy / Q000379:methods; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life; D012042:Registries; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D000875:Anthralin; D008727:Methotrexate
keywords: Childhood; MTX; children; daily clinical practice; juvenile; methotrexate; pediatric psoriasis; systemic treatment