Methotrexate dosing regimen for plaque-type psoriasis: an update of a systematic review.

IF 2.9 4区医学 Q2 DERMATOLOGY

Journal of Dermatological Treatment Pub Date : 2022-12-01 DOI:10.1080/09546634.2022.2117539

Astrid M van Huizen, Rosie Sikkel, Anouk G M Caron, Stef P Menting, Phyllis I Spuls

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引用次数: 1

Abstract

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.

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甲氨蝶呤给药方案治疗斑块型银屑病:一项系统综述的更新。

背景:甲氨蝶呤(MTX)是一种治疗斑块型银屑病的全身药物。在批准时，没有进行剂量范围研究。目前，缺乏统一的给药方案。这可能导致该药治疗效果欠佳。目的:总结有关银屑病患者甲氨蝶呤给药方案的文献。方法:对银屑病甲氨蝶呤给药方案的随机对照试验和综合证据(AgEv)文献进行综述。纳入了银屑病和AgEv患者口服、皮下或肌肉注射MTX的所有随机对照试验(RCTs)。检索截止到2022年6月20日的MEDLINE、EMBASE和CENTRAL数据库。这个SR登记在普洛斯彼罗。结果:39项随机对照试验存在高偏倚风险。试验剂量仅在3个随机对照试验中给出。在随机对照试验中，MTX的起始剂量通常为7.5 mg/周(n = 13)。在AgEv中，MTX的起始剂量大多为15mg /周(n = 5)。一项指南建议使用试验剂量，而在其他综合证据中，没有提到甚至不鼓励使用试验剂量。结论:甲氨蝶呤治疗牛皮癣缺乏高质量的证据，现有数据也存在异质性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Dermatological Treatment 医学-皮肤病学

CiteScore

6.50

自引率

0.00%

发文量

145

审稿时长

6-12 weeks

期刊介绍： The Journal of Dermatological Treatment covers all aspects of the treatment of skin disease, including the use of topical and systematically administered drugs and other forms of therapy. The Journal of Dermatological Treatment is positioned to give dermatologists cutting edge information on new treatments in all areas of dermatology. It also publishes valuable clinical reviews and theoretical papers on dermatological treatments.