Please use this identifier to cite or link to this item: http://hdl.handle.net/2381/40263
Title: The role of oral methotrexate as a steroid sparing agent in refractory eosinophilic asthma
Authors: Bilocca, David
Hargadon, B.
Pavord, I. D.
Green, R. H.
Brightling, Christopher E.
Bradding, P.
Wardlaw, A. J.
Martin, N.
Murphy, A. C.
Siddiqui, S.
First Published: 1-Jun-2017
Publisher: SAGE Publications
Citation: Chronic Respiratory Disease, 2017
Abstract: The use of oral methotrexate for refractory eosinophilic asthma in a tertiary asthma referral centre, Glenfield Hospital, Leicester, was evaluated between January 2006 and December 2014. The patients ( n = 61) were carefully phenotyped at baseline with markers of airway inflammation. In addition, a structured oral methotrexate proforma was utilized to evaluate response to therapy and adverse events. Oral steroid withdrawal was attempted 3 months after commencing treatment. Several outcomes were evaluated at 12 months, including both efficacy and adverse effects; 15% ( n = 9/61) responded by achieving a decrease in daily oral corticosteroid dose (mean 8.43 (±8.76) mg), although we were unable to identify factors that predicted a treatment response. There were no other significant changes in any other clinical outcome measures. There was a high rate of adverse events (19/61 (31%)), primarily gastrointestinal/hepatitis. Our findings support the use of biological agents in preference to using oral methotrexate as a steroid sparing agent at the first instance. In the event of failure of these agents, oral methotrexate remains a therapeutic option, which can be considered in highly specialist severe asthma centres.
DOI Link: 10.1177/1479972317709650
ISSN: 1479-9723
eISSN: 1479-9731
Links: http://journals.sagepub.com/doi/10.1177/1479972317709650
http://hdl.handle.net/2381/40263
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © the authors, 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium non-commercially, provided the original author and source are credited.
Appears in Collections:Published Articles, Dept. of Infection, Immunity and Inflammation

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