Pulsed high-dose corticosteroids combined with low-dose methotrexate in severe localized scleroderma
Pulsed high-dose corticosteroids combined with low-dose methotrexate in severe localized scleroderma
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DOI：
10.1001/archderm.141.7.847
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发表时间：
2005-07-01
影响因子：
--
通讯作者：
Altmeyer, P
中科院分区：
文献类型：
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作者：
Kreuter, A;Gambichler, T;Altmeyer, P
目的：为了评价脉冲式高剂量皮质类固醇联合口服低剂量甲氨蝶呤治疗严重局限性硬皮病（LS）患者的疗效，设计：一项前瞻性、非随机、开放性试点研究。研究地点：德国波鸿一所大学医院的皮肤科。患者：15例经组织学证实的严重LS患者。干预措施：口服甲氨蝶呤（15 mg/wk）联合静脉冲击甲基强的松龙（1000毫克，每月3天）至少6个月。主要结果指标：通过临床评分、20 MHz超声检查和组织病理学分析评价治疗结果。安全性评估包括监测不良反应和临床实验室参数。在其余14例患者中，观察到活动性疾病（炎症）的所有体征显著消除，先前受影响的皮肤显著软化，导致平均+/- SD临床评分从治疗开始时的10.9 +/- 5.3降至治疗结束时的5.5 +/- 2.5（P
Objective: To evaluate the efficacy of pulsed high-dose corticosteroids combined with orally administered low-dose methotrexate therapy in patients with severe localized scleroderma (LS).Design: A prospective, nonrandomized, open pilot studySetting: Dermatology department at a university hospital in Bochum, Germany.Patients: Fifteen patients with histologically confirmed severe LS.Interventions: Oral methotrexate (15 mg/wk) combined with pulsed intravenous methylprednisolone (1000 mg for 3 days monthly) for at least 6 months.Main Outcome Measures: Treatment outcome was evaluated by means of a clinical score, 20-MHz ultrasonography, and histopathologic analysis. Safety assessment included the monitoring of adverse effects and clinical laboratory parameters.Results: One patient discontinued therapy. in most of the remaining 14 patients, significant elimination of all signs of active disease (inflammation) and remarkable softening of formerly affected sclerotic skin that resulted in a decrease of the mean +/- SD clinical score from 10.9 +/- 5.3 at the beginning to 5.5 +/- 2.5 at the end of therapy was observed (P