title: Drug Survival and Predictors of Drug Survival for Methotrexate Treatment in a Retrospective Cohort of Adult Patients with Localized Scleroderma.
abstract: Data regarding the efficacy and safety of methotrexate (MTX) in adults with localized scleroderma (LoS) is scarce. This study gathered data from a retrospective cohort of adult patients with LoS (n?=?107), treated with MTX (1993-2015). MTX drug survival and predictors thereof were analysed. After 1 and 2 years, 26% and 63% of patients stopped MTX due to disease remission, respectively. Patients with younger age at MTX initiation (hazard ratio (HR) 1.159 (95% confidence interval (CI) 1.052-1.277)) and those with no other autoimmune diseases (HR 3.268 (95% CI 1.334-8.009)) more often stopped MTX due to disease remission. In addition, 24% of patients stopped MTX due to treatment failure within one year. Patients with circumscribed superficial LoS (HR 0.221 (95% CI 0.081-0.601)) experienced treatment failure less often than those with other LoS subtypes. Finally, adding folic acid (HR 0.184 (95% CI 0.079-0.425)) and reducing treatment delay (HR 1.056 (95% CI 1.004-1.112)) could be the most important factors in minimizing MTX treatment failure in LoS in clinical practice.
authors.affiliation: Department of Dermatology, Radboud University Medical Center, 6525 GL Nijmegen, The Netherlands. Jorre.Mertens@radboudumc.nl.
authors.forename: Jorre S
authors.initials: JS
authors.lastname: Mertens
authors.forename: Juul M
authors.initials: JM
authors.lastname: van den Reek
authors.forename: Wietske
authors.initials: W
authors.lastname: Kievit
authors.forename: Peter C M
authors.initials: PC
authors.lastname: van de Kerkhof
authors.forename: Rogier M
authors.initials: RM
authors.lastname: Thurlings
authors.forename: Tim R D
authors.initials: TR
authors.lastname: Radstake
authors.forename: Marieke M B
authors.initials: MM
authors.lastname: Seyger
authors.forename: Elke M G J
authors.initials: EM
authors.lastname: de Jong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D012594:Scleroderma, Localized / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D005492:Folic Acid; D008727:Methotrexate