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文献详情 >甲氨蝶呤治疗43例顽固性皮肤红斑狼疮患者的有效性和安全性回顾... 收藏

甲氨蝶呤治疗43例顽固性皮肤红斑狼疮患者的有效性和安全性回顾研究

Efficacy and safety of methotrexate in recalcitrant cutaneous lupus erythematosus:Results of a retrospective study in 43 patients

作     者:Wenzel J Brhler S Bauer R 罗素菊 

作者机构:Department of Dermatology University of Bonn Sigmund-Freud-Strasse 25 53105 Bonn Germany 

出 版 物:《世界核心医学期刊文摘(皮肤病学分册)》 (Digest of the World Core Medical JOurnals:Dermatology)

年 卷 期:2005年第1卷第10期

页      面:32-33页

学科分类:1002[医学-临床医学] 100206[医学-皮肤病与性病学] 10[医学] 

主  题:皮肤红斑狼疮 甲氨蝶呤 回顾研究 淋巴细胞减少症 抗疟药 指导方案 免疫抑制剂 大样本研究 疾病活动度 及已 

摘      要:Background:The therapy of cutaneous lupus erythematosus (CLE) is often challenging, especially in patients resistant to topical treatment and established first-line systemic drugs such as antimalarials. Systemic corticosteroids are effective, but their use is limited due to well-known side-effects, especially in long-term treatment. In recent years several other immunosuppressive agents have been successfully applied in CLE. However, there are no large studies or explicit guidelines on the use of these drugs in CLE. Objectives:To perform a retrospective investigation of the efficacy of low-dose methotrexate (MTX) in the treatment of CLE. Methods:One hundred and thirty-nine patients with CLE were seen at our department between 2001 and 2003, of whom 43 patients required low-dose MTX. All had histologically confirmed CLE lesions. Clinical data including disease activity, additional treatment, laboratory parameters and side-effects were recorded carefully at the time of presentation. Statistical analyses were performed by paired nonparametric Wilcoxon test and Student’s t-test using SPSS 11 software. Results:MTX led to a highly significant (P 0.01) decline in disease activity. An improvement of the cutaneous lesions was recorded in nearly all patients treated with MTX (42 of 43; 98%). Severe side-effects necessitating discontinuation of MTX treatment were recorded in seven patients (16%), which quickly resolved when MTX was discontinued. Life-threatening complications were not observed. Intravenous application was tolerated better than oral administration. Interestingly, we observed a significant increase in circulating lymphocyte numbers in patients with lymphopenia ( 1.0×109 cells L-1) prior to MTX treatment. Conclusions:Our study supports earlier findings reporting the efficacy of low-dose MTX in CLE lesions, particularly in recalcitrant clinical courses. MTX treatment appears to be safe if patients are carefully selected and monitored, with particular attention

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