ABSTRACT
Methotrexate was suggested as a treatment in 1976 by Mullarkey for severe steroid-dependent asthma, in order to reduce the use of systemic steroids responsible for numerous undesired side-effects. The aim of this open trial was to study the efficacy and tolerance of Methotrexate in the short, medium and long term and after its cessation, in ten patients aged 49.2 (+/- 3.0) who were suffering from severe steroid-dependent asthma (18.5 +/- 4.8 mg of prednisone daily for at least one year). Methotrexate was given in a dose of 15-30 mg for 14.3 months (+/- 1.8) with a post-treatment follow-up for eight patients lasting 7.9 months (+/- 1.7). The efficacy was assessed on the daily dosage of prednisone and was also evaluated using the FEV1 (VEMS) (the variations expressed were a percentage of the variation from the predicted value). In the short term (six weeks) there was no significant change in the FEV1 nor in the dose of prednisone. In the medium term (12 weeks) there was evidence of a reduction in the average daily dosage of prednisone of 39.5% with an increase in the FEV1 of 14.1%. In the long term MTX was not found as effective in reducing the dose of prednisone (15.2 mg) as on the FEV1 (an increase of 5.1% on the theoretical values). There was a favourable outcome for two patients who maintained the benefit after stopping the MTX. Seven out of ten patients presented with side effects of MTX, in three of whom the drug has to be stopped.(ABSTRACT TRUNCATED AT 250 WORDS)
