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  1. Article ; Online: Methotrexate dosing regimen for plaque-type psoriasis: an update of a systematic review.

    van Huizen, Astrid M / Sikkel, Rosie / Caron, Anouk G M / Menting, Stef P / Spuls, Phyllis I

    The Journal of dermatological treatment

    2022  , Page(s) 1–15

    Abstract: Background: Methotrexate (MTX) is a systemic treatment for plaque-type psoriasis. At the time of approval, no dose-ranging studies were performed. Nowadays, a uniform dosing regimen is lacking. This might contribute to suboptimal treatment with the drug. ...

    Abstract Background: Methotrexate (MTX) is a systemic treatment for plaque-type psoriasis. At the time of approval, no dose-ranging studies were performed. Nowadays, a uniform dosing regimen is lacking. This might contribute to suboptimal treatment with the drug.
    Objective: To summarize the literature involving the MTX dosing regimens in psoriasis patients.
    Methods: In this SR, RCTs and documents with aggregated evidence (AgEv) on the MTX dosing regimen in psoriasis were summarized. All randomized controlled trials (RCTs) in which oral, subcutaneous or intramuscular MTX was used in patients with psoriasis and AgEv, were included. The MEDLINE, EMBASE and CENTRAL databases were searched up to June 20, 2022. This SR was registered in PROSPERO.
    Results: Thirty-nine RCTs had a high risk of bias. Test dosages were given in only 3 RCTs. In the RCTs, MTX was usually prescribed in a start dose of 7.5 mg/week (
    Conclusions: There is a lack of high-quality evidence and available data for dosing MTX in psoriasis is heterogeneous.
    Language English
    Publishing date 2022-09-09
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1036299-x
    ISSN 1471-1753 ; 0954-6634
    ISSN (online) 1471-1753
    ISSN 0954-6634
    DOI 10.1080/09546634.2022.2117539
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2627: Show issues Location:
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  2. Article ; Online: The wide variety of methotrexate dosing regimens for the treatment of atopic dermatitis: a systematic review.

    Caron, Anouk G M / Bloem, Manja / El Khattabi, Hajar / de Waal, Ayla C / van Huizen, Astrid M / Denswil, Nerissa P / Gerbens, Louise A A / Spuls, Phyllis I

    The Journal of dermatological treatment

    2023  Volume 35, Issue 1, Page(s) 2292962

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Adult ; Child ; Humans ; Methotrexate/therapeutic use ; Methotrexate/adverse effects ; Dermatitis, Atopic/drug therapy
    Chemical Substances Methotrexate (YL5FZ2Y5U1)
    Language English
    Publishing date 2023-12-20
    Publishing country England
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 1036299-x
    ISSN 1471-1753 ; 0954-6634
    ISSN (online) 1471-1753
    ISSN 0954-6634
    DOI 10.1080/09546634.2023.2292962
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Adalimumab combined with methotrexate versus adalimumab monotherapy in psoriasis: Three-year follow-up data of a single-blind randomized controlled trial.

    van Huizen, Astrid M / van der Kraaij, Gayle E / Busard, Celine I / Ouwerkerk, Wouter / van den Reek, Juul M P A / Menting, Stef P / Prens, Errol P / Rispens, Theo / de Vries, Annick / de Jong, Elke M G J / Lambert, Jo / van Doorn, Martijn B A / Spuls, Phyllis I

    Journal of the European Academy of Dermatology and Venereology : JEADV

    2023  Volume 37, Issue 9, Page(s) 1815–1824

    Abstract: Background: Anti-drug antibodies (ADA) are formed in patients treated with adalimumab (ADL). This might increase clearance of ADL, potentially causing a (secondary) non-response. Combination therapy of ADL and methotrexate (MTX) reduces ADA levels and ... ...

    Abstract Background: Anti-drug antibodies (ADA) are formed in patients treated with adalimumab (ADL). This might increase clearance of ADL, potentially causing a (secondary) non-response. Combination therapy of ADL and methotrexate (MTX) reduces ADA levels and has a clinical benefit in rheumatologic diseases. In psoriasis however, the long-term effectiveness and safety have not been studied.
    Objectives: To investigate the three-year follow-up data of ADL combined with MTX compared to ADL monotherapy in ADL-naive patients with moderate to severe plaque type psoriasis.
    Methods: We conducted a multicentre RCT in the Netherlands and Belgium. Randomization was performed by a centralized online randomization service. Patients were seen every 12 weeks until week 145. Outcome assessors were blinded. We collected data on drug survival, effectiveness, safety, pharmacokinetics and immunogenicity of patients that started ADL combined with MTX compared to ADL monotherapy. We present descriptive analysis and patients were analysed according to the group initially randomized to. Patients becoming non-adherent to the biologic were excluded from analyses.
    Results: Sixty-one patients were included and 37 patients (ADL group n = 17, ADL + MTX group n = 20) continued in the follow-up study after 1 year. After 109 weeks and 145 weeks, there was a trend towards longer drug survival in the ADL + MTX group compared to the ADL group (week 109: 54.8% vs. 41.4%; p = 0.326, week 145: 51.6% vs. 41.4%; p = 0.464). At week 145, 7/13 patients were treated with MTX. In the ADL group, 4/12 patients that completed the study developed ADA, and 3/13 in the ADL + MTX group.
    Conclusions: In this small study, there was no significant difference in ADL overall drug survival when it was initially combined with MTX, compared to ADL alone. Discontinuation due to adverse events was common in the combination group. To secure accessible healthcare, combination treatment of ADL and MTX can be considered in individual patients.
    MeSH term(s) Humans ; Adalimumab/therapeutic use ; Methotrexate ; Follow-Up Studies ; Antirheumatic Agents/therapeutic use ; Antirheumatic Agents/adverse effects ; Single-Blind Method ; Arthritis, Rheumatoid/drug therapy ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Monoclonal, Humanized/therapeutic use ; Treatment Outcome ; Drug Therapy, Combination ; Psoriasis/drug therapy ; Psoriasis/chemically induced ; Double-Blind Method
    Chemical Substances Adalimumab (FYS6T7F842) ; Methotrexate (YL5FZ2Y5U1) ; Antirheumatic Agents ; Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized
    Language English
    Publishing date 2023-04-17
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 1128828-0
    ISSN 1468-3083 ; 0926-9959
    ISSN (online) 1468-3083
    ISSN 0926-9959
    DOI 10.1111/jdv.19089
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3492: Show issues Location:
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    Zs.MO 413: Show issues

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  4. Article ; Online: On which evidence can we rely when prescribing off-label methotrexate in dermatological practice? - a systematic review with GRADE approach.

    van Huizen, Astrid M / Vermeulen, Francisca M / Bik, Cathelijne M J M / Borgonjen, Rinke / Karsch, Saskia A T / Kuin, Rosanna A / Gerbens, Louise A A / Spuls, Phyllis I

    The Journal of dermatological treatment

    2021  Volume 33, Issue 4, Page(s) 1947–1966

    Abstract: If an authorized drug is prescribed for a use that is not described in the Summary of Product Characteristics, this is defined as 'off-label use.' Methotrexate is often used off-label for dermatological indications. Off-label use is permitted if ... ...

    Abstract If an authorized drug is prescribed for a use that is not described in the Summary of Product Characteristics, this is defined as 'off-label use.' Methotrexate is often used off-label for dermatological indications. Off-label use is permitted if physicians can justify the treatment based on scientific evidence available to them. Our objective here was therefore to summarize the evidence for the effectiveness, efficacy, and safety of the dermatological off-label use of methotrexate in a systematic review. We searched MEDLINE, EMBASE, and CENTRAL for studies for evidence on the effectiveness, efficacy, and safety of the off-label use of methotrexate in dermatological indications up to November 2019. We used the GRADE system to rate the quality of the evidence. The search retrieved 34,583 hits of which 3566 were selected after the title and abstract screening. After the full-text screening, 143 studies were included, which involved 3688 patients in total. We found low-quality evidence for the effectiveness, efficacy, and safety of the off-label use of methotrexate in 31 dermatological diseases. To optimize the quality of evidence to support off-label use, we need high-quality studies in which well-characterized patients are treated with standardized treatments regimens using well-validated outcomes relevant to patients and physicians.
    MeSH term(s) GRADE Approach ; Humans ; Methotrexate/therapeutic use ; Off-Label Use
    Chemical Substances Methotrexate (YL5FZ2Y5U1)
    Language English
    Publishing date 2021-08-23
    Publishing country England
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 1036299-x
    ISSN 1471-1753 ; 0954-6634
    ISSN (online) 1471-1753
    ISSN 0954-6634
    DOI 10.1080/09546634.2021.1961999
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2627: Show issues Location:
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  5. Article ; Online: International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients With Psoriasis.

    van Huizen, Astrid M / Menting, Stef P / Gyulai, Rolland / Iversen, Lars / van der Kraaij, Gayle E / Middelkamp-Hup, Maritza A / Warren, Richard B / Spuls, Phyllis I / Schejtman, Adrián A / Egeberg, Alexander / Firooz, Alireza / Kumar, Alur S / Oakley, Amanda / Foulkes, Amy / Ramos, Andrea Machado Coelho / Fougerousse, Anne-Claire / Carija, Antoanela / Akman-Karakas, Ayse / Horváth, Barbara /
    Fábos, Béata / Matlock, Benjamin Hidalgo / Claréus, Birgitta Wilson / Castro, Carla / Ferrándiz, Carlos / Correa, Carolina Cortés / Marchesi, Carolina / Goujon, Catherine / Gonzalez, Cesar / Maldonado-García, César / Hong, Chih-Ho / Griffiths, Christopher E M / Vestergaard, Christian / Echeverría, Christina Mariela / de la Cruz, Claudia / Conrad, Curdin / Törocsik, Dániel / Drvar, Daniela Ledic / Balak, Deepak / Jullien, Denis / Appelen, Diebrecht / Kim, Dong Hyun / de Jong, Elke M G J / El Gamal, Emad / Laffitte, Emmanuel / Mahé, Emmanuel / Sonkoly, Enikö / Colombo, Erika Páez / Vilarrasa, Eva / Willaert, Fabienne / Novoa, Farah D / Handjani, Farhad / Valenzuela, Fernando / Vílchez-Márquez, Francisco / Gonzalez, Gabriela Otero / Krisztián, Gáspár / Damiani, Giovanni / Krnjevic-Pezic, Gordana / Pellerano, Graciela / Carretero, Gregorio / Hunter, Hamish J A / Riad, Hassan / Oon, Hazel H / Boonen, Hugo P J / Moussa, Iftin Osman / García-Doval, Ignacio / Csányi, Ildíko / Brajac, Ines / Turchin, Irina / Grozdev, Ivan / Weinberg, Jeffrey M / Nicolopoulos, Jenny / Wells, Jillian / Lambert, Jo L W / Ingram, John R / Prinz, Jörg Christoph / de Souza Sittart, José Alexandre / Sanchez, Jose Luis / Hsiao, Josephine Pa-Fan / Castro-Ayarza, Juan Raul / Maul, Julia-Tatjana / van den Reek, Juul M P A / Trcko, Katarina / Barber, Kirk / Reich, Kristian / Gebauer, Kurt Aaron / Khobzei, Kuzma / Maul, Lara V / Massari, Larisa Prpic / Fardet, Laurence / le Cleach, Laurence / Misery, Laurent / Chandrashekar, Laxmisha / Muresanu, Lidia Irinel / Lecluse, Lidian / Skov, Lone / Frez, Ma Lorna / Babic, Lucija Tomic / Puig, Lluís / Gomez, Luis Castro / Ramam, M / Dutil, Maha / El-Sayed, Mahira Hamdy / Olszewska, Malgorzata / Schram, Mandy Elvira / Franco, Manuel Dario / Llamas-Velasco, Mar / Gonçalo, Margarida / Velásquez-Lopera, Margarita M / Abad, Maria Eugenia / de Oliveira, Maria de Fátima Santos Paim / Seyger, Marieke M B / Kaštelan, Marija / Rademaker, Marius / Sikora, Mariusz / Lebwohl, Mark / Wiseman, Marni C / Ferran, Marta / van Doorn, Martijn / Danespazhooh, Maryam / Bylaite-Bucinskiene, Matilda / Gooderham, Melinda J / Polic, Melita Vukšic / de Rie, Menno A / Zheng, Min / Gómez-Flores, Minerva / Salleras I Redonnet, Montse / Silverberg, Nanette B / Doss, Nejib / Yawalkar, Nikhil / Chosidow, Olivier / Zargari, Omid / de la Cueva, Pablo / Fernandez-Peñas, Pablo / Cárdenas Rojas, Paola J / Gisondi, Paolo / Grewal, Parbeer / Sator, Paul / Luna, Paula Carolina / Félix, Paulo Antonio Oldani / Varela, Paulo / Holló, Péter / Cetkovska, Petra / Calzavara-Pinton, Piergiacomo / Ghislain, Pierre-Dominique / Araujo, Raquel Ruiz / Romiti, Ricardo / Kui, Róbert / Ceovic, Romana / Vender, Ronald / Lafuente-Urrez, Rosario Fátima / Del-Río, Rubén / Gulin, Sandra J / Handa, Sanjeev / Mahil, Satveer K / Kolalapudi, Seetharam A / Marrón, Servando E / Azimi, Seyyede Zeinab / Janmohamed, Sherief R / da Cruz Costa, Sidney Augusto / Choon, Siew Eng / Urbancek, Slavomir / Ayanlowo, Olusola / Margasin, Susana M / Wong, Tak-Wah / Mälkönen, Tarja / Hurtová, Tatiana / Reciné, Tatiana Riveros / Huldt-Nystrøm, Theis / Torres, Tiago / Liu, Tong-Yun / Leonidze, Tsira / Sharma, Vinod Kumar / Weightman, Warren / Gulliver, Wayne / Veldkamp, Wendelien

    JAMA dermatology

    2022  Volume 158, Issue 5, Page(s) 561–572

    Abstract: Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of ... ...

    Abstract Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide.
    Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics.
    Design, setting, and participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience).
    Main outcomes and measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree.
    Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients.
    Conclusions and relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.
    MeSH term(s) Adult ; Child ; Consensus ; Folic Acid ; Humans ; Methotrexate ; Psoriasis/therapy ; Surveys and Questionnaires
    Chemical Substances Folic Acid (935E97BOY8) ; Methotrexate (YL5FZ2Y5U1)
    Language English
    Publishing date 2022-04-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2701761-8
    ISSN 2168-6084 ; 2168-6068
    ISSN (online) 2168-6084
    ISSN 2168-6068
    DOI 10.1001/jamadermatol.2022.0434
    Database MEDical Literature Analysis and Retrieval System OnLINE

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