%0 Journal Article
%T The role of oral methotrexate as a steroid sparing agent in refractory eosinophilic asthma
%A AC Murphy
%A AJ Wardlaw
%A B Hargadon
%A CE Brightling
%A David Bilocca
%A ID Pavord
%A N Martin
%A P Bradding
%A RH Green
%A S Siddiqui
%J Chronic Respiratory Disease
%@ 1479-9731
%D 2018
%R 10.1177/1479972317709650
%X The use of oral methotrexate for refractory eosinophilic asthma in a tertiary asthma referral centre, Glenfield Hospital, Leicester, was evaluated between January 2006 and December 2014. The patients (n = 61) were carefully phenotyped at baseline with markers of airway inflammation. In addition, a structured oral methotrexate proforma was utilized to evaluate response to therapy and adverse events. Oral steroid withdrawal was attempted 3 months after commencing treatment. Several outcomes were evaluated at 12 months, including both efficacy and adverse effects; 15% (n = 9/61) responded by achieving a decrease in daily oral corticosteroid dose (mean 8.43 (¡À8.76) mg), although we were unable to identify factors that predicted a treatment response. There were no other significant changes in any other clinical outcome measures. There was a high rate of adverse events (19/61 (31%)), primarily gastrointestinal/hepatitis. Our findings support the use of biological agents in preference to using oral methotrexate as a steroid sparing agent at the first instance. In the event of failure of these agents, oral methotrexate remains a therapeutic option, which can be considered in highly specialist severe asthma centres
%K Asthma
%K refractory eosinophilic asthma
%K pharmacology
%K airways disease
%K exacerbations
%U https://journals.sagepub.com/doi/full/10.1177/1479972317709650