RECOMMENDATION ON USE OF METHOTREXATE IN SARCOIDOSIS PATIENTS (WASOG, 2013) AND THE BACKGROUND FOR ITS UPDATE

Abstract

RECOMMENDATION ON USE OF METHOTREXATE IN SARCOIDOSIS PATIENTS (WASOG, 2013) AND THE BACKGROUND FOR ITS UPDATE І. O. Merenkova, N. A. Vlasova Abstract In 2013 the experts of World Association of Sarcoidosis and Other Granulomatous disorders (WASOG) have published the recommendations on use of methotrexate (MTX) in sarcoidosis patients. Considering the fact that by the moment of publishing of the recommendations, there were data presented from only one small (n=24) randomized trial (Baughman R. P. et al., 2000) and limited data from observational studies, the recommendations were mainly based on case series reports and sarcoidosis experts’ opinion, collected from appropriate survey. Since that time several trials on efficacy and safety of MTX, including large retrospective studies (Fang C., et al., 2019; Vizel A. A. et al., 2020; Baughman R. P. et al., 2020) have been accomplished. Current statement of WASOG has considered these new data. Upon review of recommendations the authors concluded that based on rich body research data on short and long-term outcomes of MTX use in pulmonary sarcoidosis, published during last 8 years, MTX may be prescribed as first line medication in patients with newly diagnosed pulmonary sarcoidosis. A safety profile of MTX allows to use it at initial dose of 15 mg/week. The concomitant administration of folic acid should be limited by cases of MTX intolerance, until new research data on this matter become available. In authors’ opinion, recommendations # 4-10, in connection with MTX safety, are up-to-date and should not be revised. Key words: pulmonary sarcoidosis, methotrexate, recommendations of WASOG-2013. Ukr. Pulmonol. J. 2021;29(3):53–57.