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© 1995 British Society for Rheumatology

research-article

LOW-DOSE METHOTREXATE: AN EFFECTIVE CORTICOSTEROID-SPARING AGENT IN THE MUSCULOSKELETAL MANIFESTATIONS OF SARCOIDOSIS

O. KAYE*,{ddagger},, E. PALAZZO*, M. GROSSIN*, P. BOURGEOIS{dagger}, M. F. KAHN* and M. G. MALAISE{ddagger}

*Departments of Rheumatology, Hospital and Faculty Xavier Bichat, University Paris VII Paris, France
{dagger}Department of Rheumatology, La Pitié Hospital, University Paris VI Paris, France
{ddagger}Department of Rheumatology, State University of Liège Liège, Belgium

Correspondence to: Correspondence to: O. Kaye, Department of Rheumatology, Room 155, Floor 3; CHU du Sart-Tilman, B-4000 Liège, Belgium.

Extrapulmonary sarcoidosis, and particularly the presence of musculoskeletal complications of the disease, may require chronic corticosteroid therapy. In five patients with biopsy-proven sarcoidosis and presenting recalcitrant forms of the disease, we introduced low-dose oral methotrexate (MTX) [10 mg/week (7.5–15)] for 30 months (16–34) to control the clinical and biological symptoms as well as to try to reduce the intolerated steroid posology. Beneficial effects were observed within 8–12 weeks in all patients, which allowed a reduction of 59% (35–75) of the corticosteroid posology, and maintained with a follow-up of 3 yr in 4/5 patients. No significant toxicity was observed. MTX appears to be an efficient, safe and corticosteroid-sparing therapeutic agent for the treatment of recalcitrant musculoskeletal manifestations of sarcoidosis.

KEY WORDS: Methotrexate, Sarcoidosis, Musculoskeletal manifestations, Corticosteroids


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