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Methotrexate Offers Lasting Benefit in Juvenile Scleroderma

Clinical remission maintained for mean of 25 months for 72.9 percent of responders

TUESDAY, Jan. 8 (HealthDay News) -- Oral methotrexate provides a lasting benefit for most patients with juvenile localized scleroderma (JLS), according to a study published in the December issue of the Journal of the American Academy of Dermatology.

Francesco Zulian, M.D., of the University of Padua in Italy, and associates conducted a prospective follow-up study of a cohort of 65 patients with JLS who were previously enrolled in a randomized controlled trial where they received treatment with oral methotrexate and prednisone for the first three months to assess the therapeutic role of methotrexate over a prolonged period. A treatment response was defined as no new lesions, skin score rate of less than 1, and at least a 10 percent decrease in lesion temperature versus baseline. Clinical remission was defined as maintenance of response for at least six months on treatment, with complete clinical remission defined as maintenance of response for at least six months without treatment.

The researchers found that 73.8 percent of patients were responders; 15.4 percent relapsed by 24 months after methotrexate initiation; and 10.8 percent of patients were lost to follow-up. The majority of responders (72.9 percent) maintained clinical remission for a mean of 25 months and 27.1 percent were in clinical remission while on medication. Adverse effects were generally mild, never required discontinuation of medication, and were experienced by 48.3 percent of patients.

"Long-term methotrexate therapy is beneficial and well tolerated for JLS," the authors conclude.

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