Pulsed High-Dose Corticosteroids Combined With Low-Dose Methotrexate in Severe Localized Scleroderma PDF Print E-mail
Wednesday, 21 July 2010 02:56
Alexander Kreuter, MD; Thilo Gambichler, MD; Frank Breuckmann, MD; Sebastian Rotterdam, MD; Marcus Freitag, MD; Markus Stuecker, MD; Klaus Hoffmann, MD; Peter Altmeyer, MD
Arch Dermatol. 2005;141:847-852

Objective: To evaluate the efficacy of pulsed highdose corticosteroids combined with orally administered low-dose methotrexate therapy in patients with severe localized scleroderma (LS).

Design: A prospective, nonrandomized, open pilot study.

Setting: Dermatology department at a university hospital in Bochum, Germany.

Patients: Fifteen patients with histologically confirmed severe LS.

Interventions: Oral methotrexate (15 mg/wk) combined with pulsed intravenous methylprednisolone (1000 mg for 3 days monthly) for at least 6 months.

Main Outcome Measures: Treatment outcome was evaluated by means of a clinical score, 20-MHz ultrasonography, and histopathologic analysis. Safety assessment included the monitoring of adverse effects and clinical laboratory parameters.

Results: One patient discontinued therapy. In most of the remaining 14 patients, significant elimination of all signs of active disease (inflammation) and remarkable softening of formerly affected sclerotic skin that resulted in a decrease of the mean±SD clinical score from 10.9±5.3 at the beginning to 5.5±2.5 at the end of therapy was observed (P<.001). Clinical improvement was confirmed by histologic and ultrasonographic assessments. No serious adverse effects were noted.

Conclusions: These data suggest that pulsed high-dose corticosteroids combined with orally administered lowdose methotrexate therapy is beneficial and safe in the treatment of patients with LS. This treatment regimen should especially be considered for severe forms of LS
in which conventional treatments have failed.

Login to download your own copy of the full and original article from the link provided below

 
More articles :

» Enhanced Survival Found With Early Detection of Scleroderma-Associated PAH

Early detection of incident systemic sclerosis–associated enhanced survival in a prospective cohort study of 131 patients from the multicenter PHAROS, according to data presented at the annual meeting of the American College of Rheumatology.The...

» Scleroderma and Lupus Health Study Claims No Environmental Link To Disease

The Massachusetts Department of Public Health (DPH) has released the results of an investigation into the occurrence of and lupus, two rare chronic diseases, in South Boston. The investigation found that the prevalence of scleroderma was indeed...

» Diagnosis, Management and Prevention of Scleroderma Renal Disease

Henry Penn; Christopher P. DentonPosted: 11/14/2008; Curr Opin Rheumatol. 2008;20(6):692-696. © 2008 Lippincott Williams & WilkinsPurpose of Review: Renal complications are important in scleroderma (systemic sclerosis) and include scleroderma...

» The Role of Intravenous Immunoglobulin Preparations in the Treatment of Systemic Sclerosis

Marta Baleva and Krasimir NikolovReceived 12 June 2011; Revised 28 August 2011; Accepted 28 August 2011Scleroderma is progressive autoimmune disease associated with severe disability. The major underlying pathological process in Scleroderma is...

» Millions Around World To Observe Rare Disease Day

Millions Around World To Observe Rare Disease DayThe Relief Foundation will be joining the National Organization for Rare Disorders (NORD) and others around the world in observing World Rare Disease Day on February 28, 2011.  On this day,...

» Juvenile Localized Scleroderma: Fewer Flares With Methotrexate

was an effective and well-tolerated treatment for in a randomized, double-blind, placebo-controlled trial involving 70 patients with active disease. At the end of the 12-month study, 31 of 46 patients randomized to receive methotrexate had...