TY - JOUR
T1 - International consensus on methotrexate dosing for patients with atopic dermatitis
T2 - An eDelphi study
AU - the MTX Consensus for AD Survey Study Group
AU - Caron, Anouk G.M.
AU - van Huizen, Astrid M.
AU - Musters, Annelie A.H.
AU - Gerbens, Louise A.A.
AU - Middelkamp Hup, Maritza A.
AU - Flohr, Carsten
AU - Irvine, Alan D.
AU - Vestergaard, Christian
AU - Peris, Ketty
AU - Brandling-Bennett, Heather A.
AU - Drucker, Aaron M.
AU - Spuls, Phyllis I.
AU - Svensson, Åke
AU - Vargas, Alex Garcia
AU - Kumar, Alur
AU - Ramos, Andréa Machado Coelho
AU - Torrelo, Antonio
AU - Parodi, Aurora
AU - Matlock, Benjamín Hidalgo
AU - Sibbald, Cathryn
AU - Mazas, Cecilia
AU - Gonzalez, Cesar
AU - Cetkovska, Petra
AU - Bangert, Christine
AU - De la Cruz, Claudia
AU - Cotton, Colleen
AU - Hijnen, Dirk Jan
AU - Aceves-Villalvalzo, Dra Martha
AU - Lawley, Leslie P.
AU - Salphal, Pankaj
AU - Torres-Pradilla, Mauricio
AU - Hawryluk, Elena
AU - Pope, Elena
AU - Colombo, Erika Páez
AU - Serra, Esther
AU - Valenzuela, Fernando
AU - József, Gáspár Krisztián
AU - Melé-Ninot, Gemma
AU - Maza, Gibert
AU - Riad, Hassan
AU - Oon, Hazel
AU - Vidaurri de la-Cruz, Helena
AU - Lapeere, Hilde
AU - Lara-Corrales, Irene
AU - Miquel, Javier
AU - Mancuso, Jennifer
AU - Carrillo, Jose Manuel Carrascosa
AU - Fagre, José Sebastián
AU - Wan, Joy
AU - Lebwohl, Mark
N1 - Publisher Copyright:
© 2024 The Author(s). Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
PY - 2024
Y1 - 2024
N2 - Background: Despite the widespread off-label use of methotrexate (MTX) for the treatment of atopic dermatitis (AD), there is limited high-quality evidence on dosing regimens and existing guidelines do not provide clear recommendations regarding dosing strategies. Objective: The aim of this study was to achieve international consensus among AD experts to standardize the dosing regimen for MTX treatment in adults and children with AD. Methods: An electronic Delphi (eDelphi) study was conducted from October 2021 to September 2022. Recruitment was conducted through dermatology societies and AD interest groups. Participation was open to dermatologists and dermatology residents experienced in treating AD patients with MTX. The study consisted of three online rounds. The first round was informed by a systematic review of relevant literature, and subsequent rounds were adjusted based on the results of the previous round. Participants voted on 19 proposals using a 9-point scale (1–3 disagree, 4–6 neither agree nor disagree, 7–9 agree). Consensus was achieved when at least 70% of participants agreed, and less than 15% disagreed. Proposals that did not reach consensus in the first three rounds were discussed in a consensus meeting, where consensus was defined as less than 30% disagreement. Results: In total, 152 participants completed Round 1, 104 (68%) completed all survey rounds, and 43 (28%) joined the consensus meeting. Consensus was achieved on 7 proposals in Round 1, 4 in Round 2 and 6 in Round 3. The final 2 proposals reached consensus during the consensus meeting. Consensus topics include test dose, start dose, maximum dose, administration route, dosing schedule, management of stopping treatment, treatment duration and folic acid supplementation. Conclusions: This eDelphi study achieved consensus on 19 proposals related to MTX dosing for adults and children with AD. These results aim to guide prescribing decisions and encourage a standardized global approach to MTX use in AD.
AB - Background: Despite the widespread off-label use of methotrexate (MTX) for the treatment of atopic dermatitis (AD), there is limited high-quality evidence on dosing regimens and existing guidelines do not provide clear recommendations regarding dosing strategies. Objective: The aim of this study was to achieve international consensus among AD experts to standardize the dosing regimen for MTX treatment in adults and children with AD. Methods: An electronic Delphi (eDelphi) study was conducted from October 2021 to September 2022. Recruitment was conducted through dermatology societies and AD interest groups. Participation was open to dermatologists and dermatology residents experienced in treating AD patients with MTX. The study consisted of three online rounds. The first round was informed by a systematic review of relevant literature, and subsequent rounds were adjusted based on the results of the previous round. Participants voted on 19 proposals using a 9-point scale (1–3 disagree, 4–6 neither agree nor disagree, 7–9 agree). Consensus was achieved when at least 70% of participants agreed, and less than 15% disagreed. Proposals that did not reach consensus in the first three rounds were discussed in a consensus meeting, where consensus was defined as less than 30% disagreement. Results: In total, 152 participants completed Round 1, 104 (68%) completed all survey rounds, and 43 (28%) joined the consensus meeting. Consensus was achieved on 7 proposals in Round 1, 4 in Round 2 and 6 in Round 3. The final 2 proposals reached consensus during the consensus meeting. Consensus topics include test dose, start dose, maximum dose, administration route, dosing schedule, management of stopping treatment, treatment duration and folic acid supplementation. Conclusions: This eDelphi study achieved consensus on 19 proposals related to MTX dosing for adults and children with AD. These results aim to guide prescribing decisions and encourage a standardized global approach to MTX use in AD.
UR - http://www.scopus.com/inward/record.url?scp=85200401324&partnerID=8YFLogxK
U2 - 10.1111/jdv.20271
DO - 10.1111/jdv.20271
M3 - Article
C2 - 39087636
AN - SCOPUS:85200401324
SN - 0926-9959
JO - Journal of the European Academy of Dermatology and Venereology
JF - Journal of the European Academy of Dermatology and Venereology
ER -