中华皮肤科杂志 ›› 2021, Vol. 54 ›› Issue (5): 382-390.doi: 10.35541/cjd.20200796
中国医师协会皮肤科医师分会自身免疫病专业委员会
收稿日期:
2020-08-10
修回日期:
2021-02-22
发布日期:
2021-04-29
通讯作者:
刘晓明
E-mail:liuxm@hku-szh.org
Committee on Autoimmune Diseases, China Dermatologist Association
Received:
2020-08-10
Revised:
2021-02-22
Published:
2021-04-29
Contact:
Liu Xiaoming
E-mail:liuxm@hku-szh.org
摘要: 【摘要】 甲氨蝶呤是治疗免疫相关性皮肤病的常用药物。为规范甲氨蝶呤在免疫相关性皮肤病治疗中的应用,中国医师协会皮肤科医师分会自身免疫病专业委员会以国内外甲氨蝶呤的研究成果为基础,组织国内皮肤病专家共同讨论制定了本共识。主要内容包括甲氨蝶呤的作用机制,在银屑病、结缔组织病、自身免疫性大疱病、血管炎及皮肤T细胞淋巴瘤的治疗应用,不良反应及使用中注意事项,以及甲氨蝶呤在特殊人群的应用。
中国医师协会皮肤科医师分会自身免疫病专业委员会. [开放获取] 甲氨蝶呤治疗免疫相关性皮肤病专家共识[J]. 中华皮肤科杂志, 2021,54(5):382-390. doi:10.35541/cjd.20200796
Committee on Autoimmune Diseases, China Dermatologist Association. Expert consensus on methotrexate in the treatment of immune-associated dermatoses[J]. Chinese Journal of Dermatology, 2021, 54(5): 382-390.doi:10.35541/cjd.20200796
[1] | Dervieux T, Furst D, Lein DO, et al. Pharmacogenetic and metabolite measurements are associated with clinical status in patients with rheumatoid arthritis treated with methotrexate: results of a multicentred cross sectional observational study[J]. Ann Rheum Dis, 2005,64(8):1180⁃1185. doi: 10.1136/ard.2004. 033399. |
[2] | 黄晶, 舒晓明, 王贵, 等. 甲氨蝶呤治疗类风湿关节炎的作用机制[J]. 中华临床医师杂志(电子版), 2016,10(21):3276⁃3280. doi: 10.3877/cma.j.issn.1674⁃0785.2016.21.028. |
[3] | Pathirana D, Ormerod AD, Saiag P, et al. European S3⁃guidelines on the systemic treatment of psoriasis vulgaris[J]. J Eur Acad Dermatol Venereol, 2009,23(Suppl 2):1⁃70. doi: 10. 1111/j.1468⁃3083.2009.03389.x. |
[4] | 赵新才, 卢进, 吴红媛, 等. 大剂量甲氨蝶呤血药浓度影响因素和检测方法的研究进展[J]. 药学服务与研究, 2019,19(5):369⁃372. doi: 10.5428/pcar20190512. |
[5] | Zhu C, Liu YW, Wang SZ, et al. Associations between the C677T and A1298C polymorphisms of MTHFR and the toxicity of methotrexate in childhood malignancies: a meta⁃analysis[J]. Pharmacogenomics J, 2018,18(3):450⁃459. doi: 10.1038/tpj.2017. 34. |
[6] | Ortiz Z, Shea B, Suarez⁃Almazor ME, et al. The efficacy of folic acid and folinic acid in reducing methotrexate gastrointestinal toxicity in rheumatoid arthritis. A meta analysis of randomized controlled trials[J]. J Rheumatol, 1998,25(1):36⁃43. |
[7] | Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case⁃based presentations and evidence⁃based conclusions[J]. J Am Acad Dermatol, 2011,65(1):137⁃174. doi: 10.1016/j.jaad.2010.11.055. |
[8] | Flytström I, Stenberg B, Svensson A, et al. Methotrexate vs. ciclosporin in psoriasis: effectiveness, quality of life and safety. A randomized controlled trial[J]. Br J Dermatol, 2008,158(1):116⁃121. doi: 10.1111/j.1365⁃2133.2007.08284.x. |
[9] | Heydendael VM, Spuls PI, Opmeer BC, et al. Methotrexate versus cyclosporine in moderate⁃to⁃severe chronic plaque psoriasis[J]. N Engl J Med, 2003,349(7):658⁃665. doi: 10. 1056/NEJMoa021359. |
[10] | 中华医学会皮肤性病学分会银屑病专业委员会. 中国银屑病诊疗指南(2018完整版)[J]. 中华皮肤科杂志, 2019,52(10):667⁃710. doi: 10.35541/cjd.20190847. |
[11] | Gisondi P, Altomare G, Ayala F, et al. Italian guidelines on the systemic treatments of moderate⁃to⁃severe plaque psoriasis[J]. J Eur Acad Dermatol Venereol, 2017,31(5):774⁃790. doi: 10.1111/ jdv.14114. |
[12] | Amatore F, Villani AP, Tauber M, et al. French guidelines on the use of systemic treatments for moderate⁃to⁃severe psoriasis in adults[J]. J Eur Acad Dermatol Venereol, 2019,33(3):464⁃483. doi: 10.1111/jdv.15340. |
[13] | Micali G, Verzì AE, Giuffrida G, et al. Inverse psoriasis: from diagnosis to current treatment options[J]. Clin Cosmet Investig Dermatol, 2019,12:953⁃959. doi: 10.2147/CCID.S189000. |
[14] | Yélamos O, Puig L. Systemic methotrexate for the treatment of psoriasis[J]. Expert Rev Clin Immunol, 2015,11(5):553⁃563. doi: 10.1586/1744666X.2015.1026894. |
[15] | Singh RK, Lee KM, Ucmak D, et al. Erythrodermic psoriasis: pathophysiology and current treatment perspectives[J]. Psoriasis (Auckl), 2016,6:93⁃104. doi: 10.2147/PTT.S101232. |
[16] | Kearns DG, Chat VS, Zang PD, et al. Review of treatments for generalized pustular psoriasis[J]. J Dermatolog Treat, 2020:1⁃3. doi: 10.1080/09546634.2019.1682502. |
[17] | Arnone M, Takahashi M, Carvalho A, et al. Diagnostic and therapeutic guidelines for plaque psoriasis ⁃ Brazilian Society of Dermatology[J]. An Bras Dermatol, 2019,94(2 Suppl 1):76⁃107. doi: 10.1590/abd1806⁃4841.2019940211. |
[18] | 中华医学会皮肤性病学分会. 阿维A治疗银屑病专家共识(2017版)[J]. 中华皮肤科杂志, 2017,50(6):397⁃399. doi: 10.3760/cma.j.issn.0412⁃4030.2017.06.002. |
[19] | 中华医学会皮肤性病学分会, 中国医师协会皮肤科医师分会, 中国中西医结合学会皮肤性病专业委员会. 中国银屑病生物治疗专家共识(2019)[J]. 中华皮肤科杂志, 2019,52(12):863⁃871. doi: 10.35541/cjd.20190892. |
[20] | 中华医学会皮肤性病学分会红斑狼疮研究中心. 皮肤型红斑狼疮诊疗指南(2019版)[J]. 中华皮肤科杂志, 2019,52(3):149⁃155. doi: 10.3760/cma.j.issn.0412⁃4030.2019.03.001. |
[21] | Klein A, Vogt T, Wenzel SM, et al. Cyclosporin combined with methotrexate in two patients with recalcitrant subacute cutaneous lupus erythematosus[J]. Australas J Dermatol, 2011,52(1):43⁃47. doi: 10.1111/j.1440⁃0960.2010.00689.x. |
[22] | 中华医学会风湿病学分会, 国家皮肤与免疫疾病临床医学研究中心, 中国系统性红斑狼疮研究协作组. 2020中国系统性红斑狼疮诊疗指南[J]. 中华内科杂志, 2020,59(3):172⁃185. doi: 10.3760/cma.j.issn.0578⁃1426.2020.03.002. |
[23] | Fanouriakis A, Kostopoulou M, Alunno A, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus[J]. Ann Rheum Dis, 2019,78(6):736⁃745. doi: 10.1136/annrheumdis⁃2019⁃215089. |
[24] | 吴炜, 邓丹琪. 多发性肌炎/皮肌炎治疗研究进展[J]. 中国皮肤性病学杂志, 2020,34(3):338⁃342. doi: 10.13735/j.cjdv.1001⁃7089.201903034. |
[25] | Ruperto N, Pistorio A, Oliveira S, et al. Prednisone versus prednisone plus ciclosporin versus prednisone plus methotrexate in new⁃onset juvenile dermatomyositis: a randomised trial[J]. Lancet, 2016,387(10019):671⁃678. doi: 10.1016/S0140⁃6736(15)01021⁃1. |
[26] | 中华医学会风湿病学分会. 系统性硬化病诊断及治疗指南[J]. 中华风湿病学杂志, 2011,15(4):256⁃259. doi: 10.3760/cma.j.issn.1007⁃7480.2011.04.011. |
[27] | Kowal⁃Bielecka O, Fransen J, Avouac J, et al. Update of EULAR recommendations for the treatment of systemic sclerosis[J]. Ann Rheum Dis, 2017,76(8):1327⁃1339. doi: 10.1136/annrheumdis⁃2016⁃209909. |
[28] | Harman KE, Brown D, Exton LS, et al. British Association of Dermatologists′ guidelines for the management of pemphigus vulgaris 2017[J]. Br J Dermatol, 2017,177(5):1170⁃1201. doi: 10.1111/bjd.15930. |
[29] | Hertl M, Jedlickova H, Karpati S, et al. Pemphigus. S2 Guideline for diagnosis and treatment⁃⁃guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV)[J]. J Eur Acad Dermatol Venereol, 2015,29(3):405⁃414. doi: 10.1111/jdv.12772. |
[30] | Ryan JG. Pemphigus. A 20⁃year survey of experience with 70 cases[J]. Arch Dermatol, 1971,104(1):14⁃20. doi: 10.1001/archderm.104.1.14. |
[31] | Gürcan HM, Ahmed AR. Analysis of current data on the use of methotrexate in the treatment of pemphigus and pemphigoid[J]. Br J Dermatol, 2009,161(4):723⁃731. doi: 10.1111/j.1365⁃2133. 2009.09246.x. |
[32] | Baum S, Greenberger S, Samuelov L, et al. Methotrexate is an effective and safe adjuvant therapy for pemphigus vulgaris[J]. Eur J Dermatol, 2012,22(1):83⁃87. doi: 10.1684/ejd.2011.1611. |
[33] | 中国医疗保健国际交流促进会皮肤科分会. 寻常型天疱疮诊断和治疗专家建议(2020)[J]. 中华皮肤科杂志, 2020,53(1):1⁃7. doi: 10.35541/cjd.20190703. |
[34] | 朱学骏, 赵景辉, 陈喜雪. 重症天疱疮21例治疗分析[J]. 临床皮肤科杂志, 2003,32(3):132⁃134. doi: 10.3969/j.issn.1000⁃4963.2003.03.006. |
[35] | Amagai M, Tanikawa A, Shimizu T, et al. Japanese guidelines for the management of pemphigus[J]. J Dermatol, 2014,41(6):471⁃486. doi: 10.1111/1346⁃8138.12486. |
[36] | Eming R, Sticherling M, Hofmann SC, et al. S2k guidelines for the treatment of pemphigus vulgaris/foliaceus and bullous pemphigoid[J]. J Dtsch Dermatol Ges, 2015,13(8):833⁃844. doi: 10.1111/ddg.12606. |
[37] | 中国医师协会皮肤科医师分会自身免疫性疾病亚专业委员. 大疱性类天疱疮诊断和治疗的专家建议[J]. 中华皮肤科杂志, 2016,49(6):384⁃387. doi: 10.3760/cma.j.issn.0412⁃4030. 2016.06.003. |
[38] | 王娣, 陈喜雪, 朱学骏. 124例大疱性类天疱疮治疗回顾[J]. 中华皮肤科杂志, 2007,40(1):7⁃9. doi: 10.3760/j.issn:0412⁃4030.2007.01.005. |
[39] | Chen KR, Carlson JA. Clinical approach to cutaneous vasculitis[J]. Am J Clin Dermatol, 2008,9(2):71⁃92. doi: 10.2165/0012 8071⁃200809020⁃00001. |
[40] | Pagnoux C, Guillevin L. Treatment of granulomatosis with polyangiitis (Wegener′s)[J]. Expert Rev Clin Immunol, 2015,11(3):339⁃348. doi: 10.1586/1744666X.2015.1008455. |
[41] | De Groot K, Rasmussen N, Bacon PA, et al. Randomized trial of cyclophosphamide versus methotrexate for induction of remission in early systemic antineutrophil cytoplasmic antibody⁃associated vasculitis[J]. Arthritis Rheum, 2005,52(8):2461⁃2469. doi: 10.1002/art.21142. |
[42] | Hirohata S, Suda H, Hashimoto T. Low⁃dose weekly methotrexate for progressive neuropsychiatric manifestations in Behcet′s disease[J]. J Neurol Sci, 1998,159(2):181⁃185. doi: 10.1016/s0022⁃510x(98)00165⁃8. |
[43] | Jorizzo JL, White WL, Wise CM, et al. Low⁃dose weekly methotrexate for unusual neutrophilic vascular reactions: cutaneous polyarteritis nodosa and Behçet′s disease[J]. J Am Acad Dermatol, 1991,24(6 Pt 1):973⁃978. doi: 10.1016/0190⁃9622(91)70156⁃v. |
[44] | Kikuchi H, Aramaki K, Hirohata S. Low dose MTX for progressive neuro⁃Behçet′s disease. A follow⁃up study for 4 years[J]. Adv Exp Med Biol, 2003,528:575⁃578. doi: 10.1007/0⁃306⁃48382⁃3_117. |
[45] | Borhani⁃Haghighi A, Kardeh B, Banerjee S, et al. Neuro⁃Behcet′s disease: an update on diagnosis, differential diagnoses, and treatment[J]. Mult Scler Relat Disord, 2019,39:101906. doi: 10.1016/j.msard.2019.101906. |
[46] | Ahronowitz I, Harp J, Shinkai K. Etiology and management of pyoderma gangrenosum: a comprehensive review[J]. Am J Clin Dermatol, 2012,13(3):191⁃211. doi: 10.2165/11595240⁃00000 0000⁃00000. |
[47] | Alavi A, French LE, Davis MD, et al. Pyoderma gangrenosum: an update on pathophysiology, diagnosis and treatment[J]. Am J Clin Dermatol, 2017,18(3):355⁃372. doi: 10.1007/s40257⁃017⁃0251⁃7. |
[48] | Ahn C, Negus D, Huang W. Pyoderma gangrenosum: a review of pathogenesis and treatment[J]. Expert Rev Clin Immunol, 2018,14(3):225⁃233. doi: 10.1080/1744666X.2018.1438269. |
[49] | Kannangara AP, Levitan D, Fleischer AB Jr. Evaluation of the efficacy of the combination of oral bexarotene and methotrexate for the treatment of early stage treatment⁃refractory cutaneous T⁃cell lymphoma[J]. J Dermatolog Treat, 2009,20(3):169⁃176. doi: 10.1080/09546630802562427. |
[50] | Zackheim HS, Kashani⁃Sabet M, McMillan A. Low⁃dose methotrexate to treat mycosis fungoides: a retrospective study in 69 patients[J]. J Am Acad Dermatol, 2003,49(5):873⁃878. doi: 10.1016/s0190⁃9622(03)01591⁃3. |
[51] | Avilés A, Nambo MJ, Neri N, et al. Interferon and low dose methotrexate improve outcome in refractory mycosis fungoides/Sézary syndrome[J]. Cancer Biother Radiopharm, 2007,22(6):836⁃840. doi: 10.1089/cbr.2007.0402. |
[52] | Warren RB, Weatherhead SC, Smith CH, et al. British Association of Dermatologists′ guidelines for the safe and effective prescribing of methotrexate for skin disease 2016[J]. Br J Dermatol, 2016,175(1):23⁃44. doi: 10.1111/bjd.14816. |
[53] | Maybury CM, Jabbar⁃Lopez ZK, Wong T, et al. Methotrexate and liver fibrosis in people with psoriasis: a systematic review of observational studies[J]. Br J Dermatol, 2014,171(1):17⁃29. doi: 10.1111/bjd.12941. |
[54] | Maybury CM, Samarasekera E, Douiri A, et al. Diagnostic accuracy of noninvasive markers of liver fibrosis in patients with psoriasis taking methotrexate: a systematic review and meta⁃analysis[J]. Br J Dermatol, 2014,170(6):1237⁃1247. doi: 10. 1111/bjd.12905. |
[55] | 刘平, 慕永平, 刘成海. 加强肝纤维化的诊断与治疗研究[J]. 中华肝脏病杂志, 2012,20(8):561⁃562. doi: 10.3760/cma.j.issn.1007⁃3418.2012.08.001. |
[56] | Ramsey LB, Balis FM, O′Brien MM, et al. Consensus guideline for use of glucarpidase in patients with high⁃dose methotrexate induced acute kidney injury and delayed methotrexate clearance[J]. Oncologist, 2018,23(1):52⁃61. doi: 10.1634/theoncologist. 2017⁃0243. |
[57] | Menting SP, Dekker PM, Limpens J, et al. Methotrexate dosing regimen for plaque⁃type psoriasis: a systematic review of the use of test⁃dose, start⁃dose, dosing scheme, dose adjustments, maximum dose and folic acid supplementation[J]. Acta Derm Venereol, 2016,96(1):23⁃28. doi: 10.2340/00015555⁃2081. |
[58] | Götestam Skorpen C, Hoeltzenbein M, Tincani A, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation[J]. Ann Rheum Dis, 2016,75(5):795⁃810. doi: 10.1136/annrheumdis⁃2015⁃208840. |
[59] | Nast A, Jacobs A, Rosumeck S, et al. Methods report: European S3⁃Guidelines on the systemic treatment of psoriasis vulgaris⁃⁃update 2015⁃⁃EDF in cooperation with EADV and IPC[J]. J Eur Acad Dermatol Venereol, 2015,29(12):e1⁃e22. doi: 10.1111/jdv.13353. |
[60] | Ruperto N, Pistorio A, Oliveira S, et al. Prednisone versus prednisone plus ciclosporin versus prednisone plus methotrexate in new⁃onset juvenile dermatomyositis: a randomised trial[J]. Lancet, 2016,387(10019):671⁃678. doi: 10.1016/S0140⁃6736(15)01021⁃1. |
[61] | Zulian F, Martini G, Vallongo C, et al. Methotrexate treatment in juvenile localized scleroderma: a randomized, double⁃blind, placebo⁃controlled trial[J]. Arthritis Rheum, 2011,63(7):1998⁃2006. doi: 10.1002/art.30264. |
[62] | Zulian F, Vallongo C, Patrizi A, et al. A long⁃term follow⁃up study of methotrexate in juvenile localized scleroderma (morphea)[J]. J Am Acad Dermatol, 2012,67(6):1151⁃1156. doi: 10.1016/j.jaad.2012.03.036. |
[63] | Huber AM, Giannini EH, Bowyer SL, et al. Protocols for the initial treatment of moderately severe juvenile dermatomyositis: results of a Children′s Arthritis and Rheumatology Research Alliance Consensus Conference[J]. Arthritis Care Res (Hoboken), 2010,62(2):219⁃225. doi: 10.1002/acr.20071. |
[64] | Hawley DP, Camina N, Rangaraj S. British isles survey of methotrexate monitoring practice during treatment of juvenile idiopathic arthritis[J]. Semin Arthritis Rheum, 2011,40(4):358⁃364.e1⁃e2. doi: 10.1016/j.semarthrit.2010.05.001. |
[65] | Ortiz⁃Alvarez O, Morishita K, Avery G, et al. Guidelines for blood test monitoring of methotrexate toxicity in juvenile idiopathic arthritis[J]. J Rheumatol, 2004,31(12):2501⁃2506. |
[66] | Raaby L, Zachariae C, Østensen M, et al. Methotrexate use and monitoring in patients with psoriasis: a consensus report based on a Danish expert meeting[J]. Acta Derm Venereol, 2017,97(4):426⁃432. doi: 10.2340/00015555⁃2599. |
[67] | Morgacheva O, Furst DE. Use of MTX in the elderly and in patients with compromised renal function[J]. Clin Exp Rheumatol, 2010,28(5 Suppl 61):S85⁃S94. |
[68] | van Winden M, van der Schoot LS, van de L′Isle Arias M, et al. Effectiveness and safety of systemic therapy for psoriasis in older adults: a systematic review[J]. JAMA Dermatol, 2020,156(11):1229⁃1239. doi: 10.1001/jamadermatol.2020.2311. |
[69] | Visser K, Katchamart W, Loza E, et al. Multinational evidence⁃based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative[J]. Ann Rheum Dis, 2009,68(7):1086⁃1093. doi:10.1136/ard.2008. 094474. |
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