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International Edelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients With Psoriasis Publisher Pubmed



Van Huizen AM1 ; Menting SP2 ; Gyulai R3 ; Iversen L4 ; Van Der Kraaij GE1 ; Middelkamphup MA1 ; Warren RB5 ; Spuls PI1 ; Schejtman AA6 ; Egeberg A7 ; Firooz A8 ; Kumar AS9 ; Oakley A10 ; Foulkes A5 Show All Authors
Authors
  1. Van Huizen AM1
  2. Menting SP2
  3. Gyulai R3
  4. Iversen L4
  5. Van Der Kraaij GE1
  6. Middelkamphup MA1
  7. Warren RB5
  8. Spuls PI1
  9. Schejtman AA6
  10. Egeberg A7
  11. Firooz A8
  12. Kumar AS9
  13. Oakley A10
  14. Foulkes A5
  15. Ramos AMC11
  16. Fougerousse AC12
  17. Carija A13
  18. Akmankarakas A14
  19. Horvath B15
  20. Fabos B16
  21. Matlock BH17
  22. Clareus BW18
  23. Castro C19
  24. Ferrandiz C20
  25. Correa CC21, 22
  26. Marchesi C23
  27. Goujon C24
  28. Gonzalez C21
  29. Maldonadogarcia C26
  30. Hong CH27
  31. Griffiths CEM5
  32. Vestergaard C4
  33. Echeverria CM28
  34. De La Cruz C29
  35. Conrad C30
  36. Drvar DL31
  37. Jullien D32
  38. Appelen D33
  39. Kim DH34
  40. De Jong EMGJ33
  41. El Gamal E35
  42. Laffitte E36
  43. Mahe E37
  44. Sonkoly E38
  45. Colombo EP39
  46. Vilarrasa E40
  47. Willaert F41
  48. Novoa FD42
  49. Handjani F43
  50. Valenzuela F44
  51. Vilchezmarquez F45
  52. Gonzalez GO46
  53. Damiani G47, 48
  54. Krnjevicpezic G49
  55. Pellerano G50
  56. Carretero G51
  57. Hunter HJA5
  58. Riad H52
  59. Oon HH53
  60. Boonen HPJ54
  61. Moussa IO55
  62. Garciadoval I56
  63. Csanyi I57
  64. Brajac I58
  65. Turchin I59, 60, 61
  66. Grozdev I62
  67. Weinberg JM63
  68. Nicolopoulos J64
  69. Wells J65
  70. Ingram JR66
  71. Prinz JC67
  72. De Souza Sittart JA68
  73. Sanchez JL69
  74. Hsiao JPF70
  75. Castroayarza JR71
  76. Maul JT72
  77. Van Den Reek JMPA73
  78. Trcko K74
  79. Barber K75
  80. Reich K76
  81. Gebauer KA77
  82. Khobzei K78
  83. Maul LV79
  84. Massari LP80
  85. Fardet L81
  86. Le Cleach L82, 83
  87. Misery L84
  88. Chandrashekar L85
  89. Muresanu LI86
  90. Lecluse L87
  91. Skov L88, 89
  92. Frez ML90
  93. Babic LT91
  94. Puig L92
  95. Gomez LC93
  96. Ramam M94
  97. Dutil M95
  98. Elsayed MH96
  99. Olszewska M97
  100. Schram ME98
  101. Franco MD99
  102. Llamasvelasco M100
  103. Goncalo M101
  104. Velasquezlopera MM102
  105. Abad ME103
  106. De Oliveira MDFSP104
  107. Seyger MMB105
  108. Kastelan M106
  109. Rademaker M107
  110. Sikora M108
  111. Lebwohl M63
  112. Wiseman MC109
  113. Ferran M110
  114. Van Doorn M111
  115. Danespazhooh M112
  116. Bylaitebucinskiene M113
  117. Gooderham MJ114
  118. Polic MV115
  119. De Rie MA1
  120. Zheng M116
  121. Gomezflores M117
  122. Salleras I Redonnet M118
  123. Silverberg NB63
  124. Doss N119
  125. Yawalkar N120
  126. Chosidow O121
  127. Zargari O122
  128. De La Cueva P123
  129. Fernandezpenas P124
  130. Cardenas Rojas PJ125
  131. Gisondi P126
  132. Grewal P127
  133. Sator P128
  134. Luna PC129
  135. Felix PAO130
  136. Varela P131
  137. Hollo P132
  138. Cetkovska P133
  139. Calzavarapinton P134
  140. Ghislain PD135
  141. Araujo RR65
  142. Romiti R136
  143. Kui R137
  144. Ceovic R138
  145. Vender R139
  146. Lafuenteurrez RF140
  147. Delrio R141
  148. Gulin SJ142
  149. Handa S143
  150. Mahil SK144
  151. Kolalapudi SA145
  152. Marron SE146, 147
  153. Azimi SZ148
  154. Janmohamed SR149
  155. Da Cruz Costa SA150
  156. Choon SE151
  157. Urbancek S152
  158. Ayanlowo O153
  159. Margasin SM154
  160. Wong TW155
  161. Malkonen T156
  162. Hurtova T157
  163. Recine TR158
  164. Huldtnystrom T159
  165. Torres T160
  166. Liu TY161
  167. Leonidze T162
  168. Sharma VK163
  169. Weightman W164
  170. Gulliver W165
  171. Veldkamp W25

Source: JAMA Dermatology Published:2022


Abstract

Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide. Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics. Design, Setting, and Participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience). Main Outcomes and Measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients. Conclusions and Relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis. © 2022 American Medical Association. All rights reserved.
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