Methotrexate as a possible therapeutic in pediatric patients with atopic dermatitis: efficacy and safety
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Caroline F. Formigari, MD, Pryscilla F. Silva, MD, Pamela A. Barbosa, MD, Gislane S. Juliao, MD, Myllena A. Cunha, MD, Antonio C. Pastorino, MD, PhD, Ana Paula C. Moschione, MD, PhD, Mayra B. Dorna, MD, Cristiane N Santos, MD
RATIONALE: Patients with severe atopic dermatitis (AD) demand long treatments with anti-inflammatory drugs. Methotrexate (MTX) is an alternative especially for adults, but there are few reports in pediatric patients.

METHODS: Retrospective study that included pediatric patients with moderate to severe atopic dermatitis (MAD/SAD) who were unresponsive to classical treatment. Patients received MTX for a minimum period of 6 months. Clinical improvement was evaluated through regular visits and SCORAD index besides monitoring clinical adverse events and on the CBC.

RESULTS: Ten pediatric patients with MAD/SAD were included in this study, age from 7 to 16 years old. The dose range for MTX was between 5mg and 15mg orally/week; the median time of treatment was 1 year (minimum of 6 months and maximum time of 2 years and 7 months). The response to treatment was evaluated by change in SCORAD (SCORing Atopic Dermatitis), and the global assessment of the clinical response score. After 1 year of treatment, we observed an objective response in most patients with SCORAD decreased and improvement in sleep scores in 6 patients (60%). Tolerance of treatment was good, gastrointestinal side-effects or infection were not observed and no patients presented significant changes on CBC.

CONCLUSIONS: A low dose of MTX could be effective and safe in uncontrolled pediatric AD. Although there are few studies with MTX on pediatric population, this medication can promote important improvement in the quality of life of patients, and should be remembered as a safe long term treatment option.