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 :

» Optical Coherence Tomography: The first Quantitative Imaging Biomarker for Scleroderma

Using the , manufactured in the UK by Michelson Diagnostics Ltd, scientists at the Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds have developed the first quantitative imaging biomarker for skin involvement in . Scleroderma...

» Unite Against Scleroderma A Great Success

Our very first Scleroderma Awareness Walk, "Unite Against Scleroderma" was a great success. Sunday May 1st was a dream that became a reality, simply because family and friends of the Foundation also wanted the community of Trinidad and Tobago to be...

» Capillaroscopy, Autoantibody Findings Predict Raynaud's Progression

Abnormal findings on nailfold and the presence of scleroderma-specific autoantibodies in patients presenting with new-onset without overt connective tissue disease are powerful independent predictors of progression to definite .A landmark Canadian...

» Scleroderma Renal Crisis: A Pathology Perspective

Ibrahim Batal, Robyn T. Domsic, Thomas A.Medsger Jr., and Sheldon BastackyInternational Journal of RheumatologyVolume 2010, Article ID 543704Scleroderma renal crisis (SRC) is an infrequent but serious complication of systemic sclerosis (SSc). It is...

» Silicone and Scleroderma Revisited

Silicone, a synthetic polymer considered to be a biologically inert substance, is used in a multitude of medical products, the most publicly recognized of which are breast implants. Silicone breast implants have been in use since the early 1960s for...

» Scientists and Clinicians Address Diagnosis and Treatment for Autoimmune and Autoinflammatory Diseases

Autoimmune and autoinflammatory diseases are a major health issue. The National Institutes of Health reports that up to 23.5 million Americans are afflicted. The American Autoimmune Related Diseases Association reports the number is closer to 50...