Methotrexate Offers Lasting Benefit in Juvenile Scleroderma
(HealthDay News) – Oral methotrexate provides a lasting benefit for most patients with juvenile localized scleroderma (JLS), according to a study published in the December issue of the Journal of the American Academy of Dermatology.
Francesco Zulian, MD, of the University of Padua in Italy, and associates conducted a prospective follow-up study of a cohort of 65 patients with JLS who were previously enrolled in a randomized controlled trial where they received treatment with oral methotrexate and prednisone for the first three months to assess the therapeutic role of methotrexate over a prolonged period. A treatment response was defined as no new lesions, skin score rate of <1%, and ≥10% decrease in lesion temperature vs. baseline. Clinical remission was defined as maintenance of response for ≥6 months on treatment, with complete clinical remission defined as maintenance of response for ≥6 months without treatment.
The researchers found that 73.8% of patients were responders; 15.4% relapsed by 24 months after methotrexate initiation; and 10.8% of patients were lost to follow-up. The majority of responders (72.9%) maintained clinical remission for a mean of 25 months and 27.1% were in clinical remission while on medication. Adverse effects were generally mild, never required discontinuation of medication, and were experienced by 48.3% of patients.
"Long-term methotrexate therapy is beneficial and well tolerated for JLS," the authors conclude.