Considerable variation among Iranian dermatologists in the dosing and monitoring of methotrexate for treating psoriasis. (18th October 2013)

• Record Type: Journal Article
• Authors: Zargari, Omid; Hejazi, Somayeh; Shahidi‐Dadras, Mohamad; Younespour, Shima; Robati, Reza; Firooz, Alireza; Toosi, Parviz; Feldman, Steven R.
• Is Part Of: International journal of dermatology. Volume 53:Number 3(2014:Mar.)
• Page Start: 385
• Page End: 389
• Publication Date: 2013-10-18
• Subjects: Dermatology -- Periodicals; 616.5
• DOI: 10.1111/ijd.12201
• Languages: English
• ISSNs: 0011-9059

Abstract

<abstract abstract-type="main" id="ijd12201-abs-0001"> <title>Abstract</title> <sec id="ijd12201-sec-0001" sec-type="section"> <title>Background</title> <p>Methotrexate (MTX) is a risky medication requiring careful attention to dosing and monitoring. Dosing and monitoring practices are not well characterized.</p> </sec> <sec id="ijd12201-sec-0002" sec-type="section"> <title>Aims</title> <p>The aim of this study was to assess variation in the dosing and monitoring of methotrexate among Iranian dermatologists.</p> </sec> <sec id="ijd12201-sec-0003" sec-type="section"> <title>Methods</title> <p>A questionnaire was administered to forty experts in psoriasis concerning the use of MTX.</p> </sec> <sec id="ijd12201-sec-0004" sec-type="section"> <title>Results</title> <p>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 7.5ٲ–50 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.</p> </sec> <sec id="ijd12201-sec-0005" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>