Methotrexate efficiency for treatment of corticosteroid-dependent asthmatic patients

Objective. To evaluate the efficiency of low doses of methotrexate as corti costeroid sparing agent in asthmatic patients requiring long term corticost eroid therapy. Methods. A prospective study was conducted with seven adult patients and on e female pediatric patient suffering from corticosteroid-dependent bronchia l asthma. The minimal stabilization time for each patient before initiating treatment with MTX was 3 months. The administered dose of methotrexate was 10 mg/week p.o. for adult patients and 15 mg/week for the pediatric patien t. Dose tapering of methyl-prednisolone both during the stabilization and t herapy periods was a 2 mg decrease every two weeks provided that no worseni ng in FEV1 higher than 5% occurred. Results. For the group of adult patients, the stabilization time was 5.6 +/ - 2.7 months. Methylprednisolone dose during the stabilization period could be decreased hem 15.0 mg down to 25.4 +/- 12.0 mg (p = 0.013). The period of treatment of methotrexate was 7.3 +/- 3.4 months and the dose of methyl- prednisolone could be decreased from 25.4 +/- 12.0 mg down to 12.0 +/- 11.9 mg (p < 0.001). In the pediatric patient, the deflazacor dose was decrease d from 60 down to 30 mg/day during treatment with methotrexate. In all pati ents a significant decrease could be obtained in the MP dose during treatme nt with methotrexate with no decrease in FEV1. No secondary effects were ob served with the exception of a labial herpes in the pediatric patient. Conclusions. The administration of one single weekly dose of methotrexate 1 0 mg in adults and 15 in one pediatric patient allowed for a decrease of ap proximately 50% in the glucocorticosteroid dosage in this group of patients with corticosteroid-dependent bronchial asthma with no relevant adverse re actions during therapy.