Treatment of dermatomyositis with methotrexate

Mary E. Zieglschmid-Adams, Amit G. Pandya, Stanley B. Cohen, Richard D. Sontheimer

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background: No published data exist on the incidence of liver fibrosis in patients with dermatomyositis treated with methotrexate. Objective: Our purpose was to examine the efficacy, steroid-sparing potential, and side effects of methotrexate in patients with dermatomyositis and to report liver biopsy results in four patients. Methods: A retrospective review of all cases of dermatomyositis treated with methotrexate in a dermatology and rheumatology referral practice was conducted. Results: Of the 10 cases reviewed, seven were of dermatomyositis whereas three were of amyopathic dermatomyositis (ADM). Nine patients received oral methotrexate. One patient received intravenous methotrexate. Improvement of cutaneous disease occurred in seven (100%) of the patients with dermatomyositis and in two (66%) of those with ADM; myositis improved in four (57%) of the patients with dermatomyositis. The initial prednisone dose was halved after an average of 18 weeks of methotrexate therapy in the patients with dermatomyositis and 13 weeks in the patients with ADM. Methotrexate-related side effects occurred in six (86%) of the patients with dermatomyositis and in one (33%) of the patients with ADM. Of the four patients who had liver biopsies, two (50%) showed mild hepatic fibrosis, resulting in discontinuation of the drug. Both patients in whom fibrosis developed had preexisting steroid-induced diabetes mellitus. Conclusion: Although methotrexate is an effective treatment for dermatomyositis, side effects are common. Patients with diabetes mellitus should be closely monitored for toxic effects on the liver.

Original languageEnglish (US)
Pages (from-to)754-757
Number of pages4
JournalJournal of the American Academy of Dermatology
Volume32
Issue number5 PART 1
DOIs
StatePublished - 1995

Fingerprint

Dermatomyositis
Methotrexate
Therapeutics
Liver
Diabetes Mellitus
Fibrosis
Steroids
Biopsy
Myositis
Poisons
Rheumatology
Dermatology
Prednisone
Skin Diseases
Liver Cirrhosis

ASJC Scopus subject areas

  • Dermatology

Cite this

Zieglschmid-Adams, M. E., Pandya, A. G., Cohen, S. B., & Sontheimer, R. D. (1995). Treatment of dermatomyositis with methotrexate. Journal of the American Academy of Dermatology, 32(5 PART 1), 754-757. https://doi.org/10.1016/0190-9622(95)91455-2

Treatment of dermatomyositis with methotrexate. / Zieglschmid-Adams, Mary E.; Pandya, Amit G.; Cohen, Stanley B.; Sontheimer, Richard D.

In: Journal of the American Academy of Dermatology, Vol. 32, No. 5 PART 1, 1995, p. 754-757.

Research output: Contribution to journalArticle

Zieglschmid-Adams, ME, Pandya, AG, Cohen, SB & Sontheimer, RD 1995, 'Treatment of dermatomyositis with methotrexate', Journal of the American Academy of Dermatology, vol. 32, no. 5 PART 1, pp. 754-757. https://doi.org/10.1016/0190-9622(95)91455-2
Zieglschmid-Adams, Mary E. ; Pandya, Amit G. ; Cohen, Stanley B. ; Sontheimer, Richard D. / Treatment of dermatomyositis with methotrexate. In: Journal of the American Academy of Dermatology. 1995 ; Vol. 32, No. 5 PART 1. pp. 754-757.
@article{5c36072fa77c40e18a9a5c3fcfa33ae7,
title = "Treatment of dermatomyositis with methotrexate",
abstract = "Background: No published data exist on the incidence of liver fibrosis in patients with dermatomyositis treated with methotrexate. Objective: Our purpose was to examine the efficacy, steroid-sparing potential, and side effects of methotrexate in patients with dermatomyositis and to report liver biopsy results in four patients. Methods: A retrospective review of all cases of dermatomyositis treated with methotrexate in a dermatology and rheumatology referral practice was conducted. Results: Of the 10 cases reviewed, seven were of dermatomyositis whereas three were of amyopathic dermatomyositis (ADM). Nine patients received oral methotrexate. One patient received intravenous methotrexate. Improvement of cutaneous disease occurred in seven (100{\%}) of the patients with dermatomyositis and in two (66{\%}) of those with ADM; myositis improved in four (57{\%}) of the patients with dermatomyositis. The initial prednisone dose was halved after an average of 18 weeks of methotrexate therapy in the patients with dermatomyositis and 13 weeks in the patients with ADM. Methotrexate-related side effects occurred in six (86{\%}) of the patients with dermatomyositis and in one (33{\%}) of the patients with ADM. Of the four patients who had liver biopsies, two (50{\%}) showed mild hepatic fibrosis, resulting in discontinuation of the drug. Both patients in whom fibrosis developed had preexisting steroid-induced diabetes mellitus. Conclusion: Although methotrexate is an effective treatment for dermatomyositis, side effects are common. Patients with diabetes mellitus should be closely monitored for toxic effects on the liver.",
author = "Zieglschmid-Adams, {Mary E.} and Pandya, {Amit G.} and Cohen, {Stanley B.} and Sontheimer, {Richard D.}",
year = "1995",
doi = "10.1016/0190-9622(95)91455-2",
language = "English (US)",
volume = "32",
pages = "754--757",
journal = "Journal of the American Academy of Dermatology",
issn = "0190-9622",
publisher = "Mosby Inc.",
number = "5 PART 1",

}

TY - JOUR

T1 - Treatment of dermatomyositis with methotrexate

AU - Zieglschmid-Adams, Mary E.

AU - Pandya, Amit G.

AU - Cohen, Stanley B.

AU - Sontheimer, Richard D.

PY - 1995

Y1 - 1995

N2 - Background: No published data exist on the incidence of liver fibrosis in patients with dermatomyositis treated with methotrexate. Objective: Our purpose was to examine the efficacy, steroid-sparing potential, and side effects of methotrexate in patients with dermatomyositis and to report liver biopsy results in four patients. Methods: A retrospective review of all cases of dermatomyositis treated with methotrexate in a dermatology and rheumatology referral practice was conducted. Results: Of the 10 cases reviewed, seven were of dermatomyositis whereas three were of amyopathic dermatomyositis (ADM). Nine patients received oral methotrexate. One patient received intravenous methotrexate. Improvement of cutaneous disease occurred in seven (100%) of the patients with dermatomyositis and in two (66%) of those with ADM; myositis improved in four (57%) of the patients with dermatomyositis. The initial prednisone dose was halved after an average of 18 weeks of methotrexate therapy in the patients with dermatomyositis and 13 weeks in the patients with ADM. Methotrexate-related side effects occurred in six (86%) of the patients with dermatomyositis and in one (33%) of the patients with ADM. Of the four patients who had liver biopsies, two (50%) showed mild hepatic fibrosis, resulting in discontinuation of the drug. Both patients in whom fibrosis developed had preexisting steroid-induced diabetes mellitus. Conclusion: Although methotrexate is an effective treatment for dermatomyositis, side effects are common. Patients with diabetes mellitus should be closely monitored for toxic effects on the liver.

AB - Background: No published data exist on the incidence of liver fibrosis in patients with dermatomyositis treated with methotrexate. Objective: Our purpose was to examine the efficacy, steroid-sparing potential, and side effects of methotrexate in patients with dermatomyositis and to report liver biopsy results in four patients. Methods: A retrospective review of all cases of dermatomyositis treated with methotrexate in a dermatology and rheumatology referral practice was conducted. Results: Of the 10 cases reviewed, seven were of dermatomyositis whereas three were of amyopathic dermatomyositis (ADM). Nine patients received oral methotrexate. One patient received intravenous methotrexate. Improvement of cutaneous disease occurred in seven (100%) of the patients with dermatomyositis and in two (66%) of those with ADM; myositis improved in four (57%) of the patients with dermatomyositis. The initial prednisone dose was halved after an average of 18 weeks of methotrexate therapy in the patients with dermatomyositis and 13 weeks in the patients with ADM. Methotrexate-related side effects occurred in six (86%) of the patients with dermatomyositis and in one (33%) of the patients with ADM. Of the four patients who had liver biopsies, two (50%) showed mild hepatic fibrosis, resulting in discontinuation of the drug. Both patients in whom fibrosis developed had preexisting steroid-induced diabetes mellitus. Conclusion: Although methotrexate is an effective treatment for dermatomyositis, side effects are common. Patients with diabetes mellitus should be closely monitored for toxic effects on the liver.

UR - http://www.scopus.com/inward/record.url?scp=0028902714&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028902714&partnerID=8YFLogxK

U2 - 10.1016/0190-9622(95)91455-2

DO - 10.1016/0190-9622(95)91455-2

M3 - Article

C2 - 7722021

AN - SCOPUS:0028902714

VL - 32

SP - 754

EP - 757

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

SN - 0190-9622

IS - 5 PART 1

ER -