RECOMMENDATION ON USE OF METHOTREXATE IN SARCOIDOSIS PATIENTS (WASOG, 2013) AND THE BACKGROUND FOR ITS UPDATE

І. O. Merenkova, N. Vlasova
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Abstract

RECOMMENDATION ON USE OF METHOTREXATE IN SARCOIDOSIS PATIENTS (WASOG, 2013) AND THE BACKGROUND FOR ITS UPDATE І. O. Merenkova, N. A. Vlasova Abstract In 2013 the experts of World Association of Sarcoidosis and Other Granulomatous disorders (WASOG) have published the recommendations on use of methotrexate (MTX) in sarcoidosis patients. Considering the fact that by the moment of publishing of the recommendations, there were data presented from only one small (n=24) randomized trial (Baughman R. P. et al., 2000) and limited data from observational studies, the recommendations were mainly based on case series reports and sarcoidosis experts’ opinion, collected from appropriate survey. Since that time several trials on efficacy and safety of MTX, including large retrospective studies (Fang C., et al., 2019; Vizel A. A. et al., 2020; Baughman R. P. et al., 2020) have been accomplished. Current statement of WASOG has considered these new data. Upon review of recommendations the authors concluded that based on rich body research data on short and long-term outcomes of MTX use in pulmonary sarcoidosis, published during last 8 years, MTX may be prescribed as first line medication in patients with newly diagnosed pulmonary sarcoidosis. A safety profile of MTX allows to use it at initial dose of 15 mg/week. The concomitant administration of folic acid should be limited by cases of MTX intolerance, until new research data on this matter become available. In authors’ opinion, recommendations # 4-10, in connection with MTX safety, are up-to-date and should not be revised. Key words: pulmonary sarcoidosis, methotrexate, recommendations of WASOG-2013. Ukr. Pulmonol. J. 2021;29(3):53–57.
关于在结节病患者中使用甲氨蝶呤的建议(wasog, 2013)及其更新的背景
关于在结节病患者中使用甲氨蝶呤的建议(wasog, 2013)及其更新背景І。2013年,世界结节病和其他肉芽肿疾病协会(WASOG)的专家发表了关于在结节病患者中使用甲氨蝶呤(MTX)的建议。考虑到到建议发表时,只有一项小型(n=24)随机试验(Baughman R. P. et al., 2000)提供的数据和观察性研究的数据有限,建议主要基于病例系列报告和结节病专家的意见,从适当的调查中收集。从那时起,几项关于MTX疗效和安全性的试验,包括大型回顾性研究(Fang C.等,2019;Vizel A. A.等,2020;鲍曼r.p.等人,2020)已经完成。WASOG目前的声明考虑了这些新数据。在回顾建议后,作者得出结论,基于近8年来发表的关于肺结节病使用MTX的短期和长期结果的丰富体研究数据,MTX可作为新诊断的肺结节病患者的一线药物。MTX的安全性允许其初始剂量为15毫克/周。在有甲氨蝶呤不耐受的情况下,应限制叶酸的同时服用,直到有关于这一问题的新研究数据。在作者看来,关于MTX安全性的建议# 4-10是最新的,不应该修改。关键词:肺结节病,甲氨蝶呤,WASOG-2013推荐Ukr。Pulmonol。j . 2021;(3): 29日53-57。
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