Drug Survival and Predictors of Drug Survival for Methotrexate Treatment in a Retrospective Cohort of Adult Patients with Localized Scleroderma
Mertens, Jorre S; van den Reek, Juul M; Kievit, Wietske; van de Kerkhof, Peter C M; Thurlings, Rogier M; Radstake, Tim R D; Seyger, Marieke M B; de Jong, Elke M G J
(2016) Acta Dermato-Venereologica, volume 96, issue 7, pp. 943 - 947
(Article)
Abstract
Data regarding the efficacy and safety of methotrexate (MTX) in adults with localized scleroderma (LoS) is scarce. This study gathered data from a retrospective cohort of adult patients with LoS (n?=?107), treated with MTX (1993-2015). MTX drug survival and predictors thereof were analysed. After 1 and 2 years, 26% and
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63% of patients stopped MTX due to disease remission, respectively. Patients with younger age at MTX initiation (hazard ratio (HR) 1.159 (95% confidence interval (CI) 1.052-1.277)) and those with no other autoimmune diseases (HR 3.268 (95% CI 1.334-8.009)) more often stopped MTX due to disease remission. In addition, 24% of patients stopped MTX due to treatment failure within one year. Patients with circumscribed superficial LoS (HR 0.221 (95% CI 0.081-0.601)) experienced treatment failure less often than those with other LoS subtypes. Finally, adding folic acid (HR 0.184 (95% CI 0.079-0.425)) and reducing treatment delay (HR 1.056 (95% CI 1.004-1.112)) could be the most important factors in minimizing MTX treatment failure in LoS in clinical practice.
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Keywords: Adolescent, Adult, Aged, Antirheumatic Agents, Child, Child, Preschool, Female, Folic Acid, Humans, Infant, Male, Methotrexate, Middle Aged, Remission Induction, Retrospective Studies, Scleroderma, Localized, Treatment Outcome, Journal Article, Journal Article
ISSN: 0001-5555
Publisher: Society for the Publication of Acta Dermato-Venereologica
(Peer reviewed)