Considerable variation among Iranian dermatologists in the dosing and monitoring of methotrexate for treating psoriasis.

Abstract:

BACKGROUND:Methotrexate (MTX) is a risky medication requiring careful attention to dosing and monitoring. Dosing and monitoring practices are not well characterized. AIMS:The aim of this study was to assess variation in the dosing and monitoring of methotrexate among Iranian dermatologists. METHODS:A questionnaire was administered to forty experts in psoriasis concerning the use of MTX. RESULTS:Among the 39 responding dermatologists (15 women, 24 men), 54% saw fewer than 10 psoriatic patients per week, 23% 10-20 patients, and 23% more than 20 patients. About half of the dermatologists treat their patients with an initial MTX dose of <7.5 mg/week (range 5-17.5 mg/week), an average dose of <10 mg/week (range 5-25 mg/week), and a maximum dose of <20 mg/week (range 7.550 – mg/week) with 71.8% prescribing the medication orally and 28.2% intramuscularly. Subcutaneous injection was preferred by none of the dermatologists as a usual route of administration. Nearly 5% of the dermatologists believe that liver biopsy should be performed prior to treatment with MTX in all patients, and another 5% consider this procedure prior to treatment only in patients with risk factors. About 44 and 33% of the dermatologists do the liver biopsy after 1.0-1.5 g and 3.54 g total cumulative doses, respectively. CONCLUSION:After more than a half century, there are still noticeable controversies on the manner of using MTX in treating psoriasis among Iranian dermatologists. A national guideline may help standardize treatment practices.

journal_name

Int J Dermatol

authors

Zargari O,Hejazi S,Shahidi-Dadras M,Younespour S,Robati R,Firooz A,Toosi P,Feldman SR

doi

10.1111/ijd.12201

subject

Has Abstract

pub_date

2014-03-01 00:00:00

pages

385-9

issue

3

eissn

0011-9059

issn

1365-4632

journal_volume

53

pub_type

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