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Methotrexate vs. ciclosporin in the treatment of severe atopic dermatitis in children: a critical appraisal
Author(s) -
Tsakok T.,
Flohr C.
Publication year - 2014
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.12820
Subject(s) - atopic dermatitis , ciclosporin , medicine , dermatology , critical appraisal , foundation (evidence) , methotrexate , family medicine , library science , alternative medicine , surgery , transplantation , political science , pathology , law , computer science
Summary Aim El‐Khalawany et al . ( Eur J Pediatr 2012; 172 : 351–6) aimed to compare the efficacy and safety of methotrexate vs. ciclosporin in the treatment of children with severe atopic eczema. Setting and design This multicentre, parallel group (ratio 1 : 1), randomized controlled trial was conducted in a secondary care setting in Egypt. Study exposure Children with severe atopic eczema were randomly assigned to receive either methotrexate (7·5 mg weekly) or ciclosporin (2·5 mg kg −1 daily) for 12 weeks, followed by a 12‐week follow‐up period. Outcomes Eczema severity was measured using the SCOR ing of Atopic Dermatitis ( SCORAD ) index. The authors also recorded the number of patients on each therapy experiencing adverse effects. Primary outcome measures The primary outcome was the mean change in SCORAD after 12 weeks of treatment. Results Forty patients with a mean age of 11·6 ± 1·52 years were included in the trial. At week 12, patients in the methotrexate group had a mean ± SD absolute reduction in SCORAD of 26·25 ± 7·03, compared with 25·02 ± 8·21 in the ciclosporin group ( P = 0·93). Both drugs were associated with minor adverse effects, none of which necessitated changing the treatment regimen. Conclusions El‐Khalawany et al . conclude that both methotrexate and ciclosporin in low doses are clinically effective, relatively safe, and well tolerated as treatments for severe atopic eczema in children.