Methotrexate, azathioprine seem safe long-term for dermatitis

(HealthDay)—Methotrexate and azathioprine appear to be effective and safe as maintenance treatments in moderate-to-severe atopic dermatitis for up to five years, according to research published online Dec. 13 in the British Journal of Dermatology.

Louise A.A. Gerbens, M.D., from the University of Amsterdam, and colleagues investigated the long-term effectiveness, safety, and drug survival of methotrexate and azathioprine in an open-label, five-year follow-up phase of a clinical trial. Of the 43 patients originally included in the trial, 27 completed the follow-up.

The researchers found that the mean relative reduction in the SCORing Atopic Dermatitis index was similar in the two groups: 52.8 and 53.8 percent, respectively, by descriptive analysis in the methotrexate and azathioprine groups. Over the five years, 11 serious adverse events occurred; a possible causal relationship existed for three of these. There was longer drug survival for methotrexate, but drug survival was low in both groups after five years (methotrexate, five patients; azathioprine, one patient).

"Based on this relatively small pragmatic study, methotrexate and azathioprine seem to be effective and safe as maintenance treatments in moderate-to-severe atopic dermatitis up to five years," the authors write. "Few patients in both groups survive on their originally allocated drug although some discontinued due to controlled atopic dermatitis."

One author disclosed financial ties to the pharmaceutical industry.

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