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An inception cohort study of methotrexate in scleroderma: Efficacy, side effects and remission outcomes

An inception cohort study in 58 patients (aged 13-74 years) with sclerotic skin disease evaluated the efficacy, side effects and remission outcomes of methotrexate 15-25 mg/week (n = 47) or methotrexate and corticosteroids (prednisolone, mean dose 17 mg/day, n = 11). The median duration of treatment ranged from 44 weeks (methotrexate) to 47 weeks (methotrexate + corticosteroids). After one treatment course, approximately half the patients (51%) treated with methotrexate achieved remission, while 37% on methotrexate + corticosteroids did so. Relapsed patients (30% on methotrexate and 27% on methotrexate + corticosteroids) still responded to second or third courses of methotrexate. Serious side effects were seen in 10% of patients; these comprised infections, gastrointestinal ...