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Reference: Bilocca, D, Hargadon, B, Pavord, ID et al., (2017). The role of oral methotrexate as a steroid sparing agent in refractory eosinophilic asthma. Chronic Respiratory Disease.Citable link to this page:

 

The role of oral methotrexate as a steroid sparing agent in refractory eosinophilic asthma.

Abstract: The use of oral methotrexate for refractory eosinophilic asthma in a tertiary asthma referral centre, Glenfield Hospital, Leicester, was evaluated between January 2006 and December 2014. The patients ( n = 61) were carefully phenotyped at baseline with markers of airway inflammation. In addition, a structured oral methotrexate proforma was utilized to evaluate response to therapy and adverse events. Oral steroid withdrawal was attempted 3 months after commencing treatment. Several outcomes were evaluated at 12 months, including both efficacy and adverse effects; 15% ( n = 9/61) responded by achieving a decrease in daily oral corticosteroid dose (mean 8.43 (±8.76) mg), although we were unable to identify factors that predicted a treatment response. There were no other significant changes in any other clinical outcome measures. There was a high rate of adverse events (19/61 (31%)), primarily gastrointestinal/hepatitis. Our findings support the use of biological agents in preference to using oral methotrexate as a steroid sparing agent at the first instance. In the event of failure of these agents, oral methotrexate remains a therapeutic option, which can be considered in highly specialist severe asthma centres.

Publication status:PublishedPeer Review status:Peer reviewedVersion:Publisher's versionDate of acceptance:2017-03-21 Funder: National Institute for Health Research   Notes:© The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Bibliographic Details

Publisher: SAGE Publications

Publisher Website: http://www.sagepub.com/

Journal: Chronic Respiratory Diseasesee more from them

Publication Website: http://journals.sagepub.com/home/crd

Extent: 1479972317709650

Issue Date: 2017-06Identifiers

Doi: https://doi.org/10.1177/1479972317709650

Issn: 1479-9731

Uuid: uuid:54520e33-ab20-49e9-89a6-2de5ebd3f5f1

Urn: uri:54520e33-ab20-49e9-89a6-2de5ebd3f5f1

Pubs-id: pubs:700939 Item Description

Type: journal-article;

Language: eng

Version: Publisher's versionKeywords: Asthma airways disease exacerbations pharmacology refractory eosinophilic asthma

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Author: Bilocca, D - - - Hargadon, B - - - Pavord, ID - Oxford, MSD, NDM, Target Discovery Institute St Edmund Hall - - - Green, RH - - -

Source: https://ora.ox.ac.uk/objects/uuid:54520e33-ab20-49e9-89a6-2de5ebd3f5f1



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