TY - JOUR
T1 - Methotrexate dosing regimen for plaque-type psoriasis
T2 - an update of a systematic review
AU - van Huizen, Astrid M.
AU - Sikkel, Rosie
AU - Caron, Anouk G. M.
AU - Menting, Stef P.
AU - Spuls, Phyllis I.
N1 - Funding Information: The authors thanks clinical librarians Jacqueline Limpens and Nerissa Denswil for their advice on the design of the search strategy and for performing the search in MEDLINE, CENTRAL and EMBASE. Publisher Copyright: © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.
PY - 2022
Y1 - 2022
N2 - Background: Methotrexate (MTX) is a systemic treatment for plaque-type psoriasis. At the time of approval, no dose-ranging studies were performed. Nowadays, a uniform dosing regimen is lacking. This might contribute to suboptimal treatment with the drug. Objective: To summarize the literature involving the MTX dosing regimens in psoriasis patients. Methods: In this SR, RCTs and documents with aggregated evidence (AgEv) on the MTX dosing regimen in psoriasis were summarized. All randomized controlled trials (RCTs) in which oral, subcutaneous or intramuscular MTX was used in patients with psoriasis and AgEv, were included. The MEDLINE, EMBASE and CENTRAL databases were searched up to June 20, 2022. This SR was registered in PROSPERO. Results: Thirty-nine RCTs had a high risk of bias. Test dosages were given in only 3 RCTs. In the RCTs, MTX was usually prescribed in a start dose of 7.5 mg/week (n = 13). MTX was mostly given in a start dose of 15 mg/week, in the AgEv (n = 5). One guideline recommended a test dose, in other aggregated evidence a test dose was not mentioned or even discouraged. Conclusions: There is a lack of high-quality evidence and available data for dosing MTX in psoriasis is heterogeneous.
AB - Background: Methotrexate (MTX) is a systemic treatment for plaque-type psoriasis. At the time of approval, no dose-ranging studies were performed. Nowadays, a uniform dosing regimen is lacking. This might contribute to suboptimal treatment with the drug. Objective: To summarize the literature involving the MTX dosing regimens in psoriasis patients. Methods: In this SR, RCTs and documents with aggregated evidence (AgEv) on the MTX dosing regimen in psoriasis were summarized. All randomized controlled trials (RCTs) in which oral, subcutaneous or intramuscular MTX was used in patients with psoriasis and AgEv, were included. The MEDLINE, EMBASE and CENTRAL databases were searched up to June 20, 2022. This SR was registered in PROSPERO. Results: Thirty-nine RCTs had a high risk of bias. Test dosages were given in only 3 RCTs. In the RCTs, MTX was usually prescribed in a start dose of 7.5 mg/week (n = 13). MTX was mostly given in a start dose of 15 mg/week, in the AgEv (n = 5). One guideline recommended a test dose, in other aggregated evidence a test dose was not mentioned or even discouraged. Conclusions: There is a lack of high-quality evidence and available data for dosing MTX in psoriasis is heterogeneous.
KW - Methotrexate
KW - dosing
KW - psoriasis
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=85138269619&partnerID=8YFLogxK
U2 - https://doi.org/10.1080/09546634.2022.2117539
DO - https://doi.org/10.1080/09546634.2022.2117539
M3 - Review article
C2 - 36043844
SN - 0954-6634
VL - 33
SP - 3104
EP - 3118
JO - Journal of Dermatological Treatment
JF - Journal of Dermatological Treatment
IS - 8
ER -