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The Long-Term Use of Methotrexate Monotherapy as a Steroid-Sparing Agent for Patients With Pulmonary Sarcoidosis
This report aims to determine the benefits of long-term use of methotrexate as a steroid-sparing agent for a patient with pulmonary sarcoidosis who cannot tolerate the glycemic effects of steroids. A search for articles using the medical subject heading terms “methotrexate” and “sarcoidosis” on PubM...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8473589/ https://www.ncbi.nlm.nih.gov/pubmed/34595077 http://dx.doi.org/10.7759/cureus.17509 |
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author | Baiyasi, Ahmad F Bangash, Najeebullah |
author_facet | Baiyasi, Ahmad F Bangash, Najeebullah |
author_sort | Baiyasi, Ahmad F |
collection | PubMed |
description | This report aims to determine the benefits of long-term use of methotrexate as a steroid-sparing agent for a patient with pulmonary sarcoidosis who cannot tolerate the glycemic effects of steroids. A search for articles using the medical subject heading terms “methotrexate” and “sarcoidosis” on PubMed involving clinical trials evaluating the therapeutic effect and toxic profile of methotrexate as a steroid-sparing agent in treating pulmonary and/or extrapulmonary symptoms of sarcoidosis was included. The literature review indicates that methotrexate is an alternative treatment for sarcoidosis, allowing the patient to avoid the long-term side effects of steroids while achieving similar rates of treatment and remission. Patients in several research studies were able to taper their steroid dosage over time when methotrexate was concurrently prescribed for the treatment of pulmonary sarcoidosis. The critical appraisal of one of the studies reviewed indicates methotrexate as a single agent in treating patients with chronic progressive pulmonary sarcoidosis, serving as a steroid alternative. Methotrexate was safe and effective for a duration of 6-24 months, with patients experiencing definite improvements in pulmonary function tests. However, not all patients in this open prospective, real-life, single-center trial demonstrated improvement. Thus, a review of the current literature is often necessary to help guide clinical decision-making for patients with chronic diseases like sarcoidosis and to determine patient characteristics of methotrexate responders. |
format | Online Article Text |
id | pubmed-8473589 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-84735892021-09-29 The Long-Term Use of Methotrexate Monotherapy as a Steroid-Sparing Agent for Patients With Pulmonary Sarcoidosis Baiyasi, Ahmad F Bangash, Najeebullah Cureus Endocrinology/Diabetes/Metabolism This report aims to determine the benefits of long-term use of methotrexate as a steroid-sparing agent for a patient with pulmonary sarcoidosis who cannot tolerate the glycemic effects of steroids. A search for articles using the medical subject heading terms “methotrexate” and “sarcoidosis” on PubMed involving clinical trials evaluating the therapeutic effect and toxic profile of methotrexate as a steroid-sparing agent in treating pulmonary and/or extrapulmonary symptoms of sarcoidosis was included. The literature review indicates that methotrexate is an alternative treatment for sarcoidosis, allowing the patient to avoid the long-term side effects of steroids while achieving similar rates of treatment and remission. Patients in several research studies were able to taper their steroid dosage over time when methotrexate was concurrently prescribed for the treatment of pulmonary sarcoidosis. The critical appraisal of one of the studies reviewed indicates methotrexate as a single agent in treating patients with chronic progressive pulmonary sarcoidosis, serving as a steroid alternative. Methotrexate was safe and effective for a duration of 6-24 months, with patients experiencing definite improvements in pulmonary function tests. However, not all patients in this open prospective, real-life, single-center trial demonstrated improvement. Thus, a review of the current literature is often necessary to help guide clinical decision-making for patients with chronic diseases like sarcoidosis and to determine patient characteristics of methotrexate responders. Cureus 2021-08-27 /pmc/articles/PMC8473589/ /pubmed/34595077 http://dx.doi.org/10.7759/cureus.17509 Text en Copyright © 2021, Baiyasi et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Endocrinology/Diabetes/Metabolism Baiyasi, Ahmad F Bangash, Najeebullah The Long-Term Use of Methotrexate Monotherapy as a Steroid-Sparing Agent for Patients With Pulmonary Sarcoidosis |
title | The Long-Term Use of Methotrexate Monotherapy as a Steroid-Sparing Agent for Patients With Pulmonary Sarcoidosis |
title_full | The Long-Term Use of Methotrexate Monotherapy as a Steroid-Sparing Agent for Patients With Pulmonary Sarcoidosis |
title_fullStr | The Long-Term Use of Methotrexate Monotherapy as a Steroid-Sparing Agent for Patients With Pulmonary Sarcoidosis |
title_full_unstemmed | The Long-Term Use of Methotrexate Monotherapy as a Steroid-Sparing Agent for Patients With Pulmonary Sarcoidosis |
title_short | The Long-Term Use of Methotrexate Monotherapy as a Steroid-Sparing Agent for Patients With Pulmonary Sarcoidosis |
title_sort | long-term use of methotrexate monotherapy as a steroid-sparing agent for patients with pulmonary sarcoidosis |
topic | Endocrinology/Diabetes/Metabolism |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8473589/ https://www.ncbi.nlm.nih.gov/pubmed/34595077 http://dx.doi.org/10.7759/cureus.17509 |
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