scholarly journals Severe bone marrow suppression accompanying pulmonary infection and hemorrhage of the digestive tract associated with leflunomide and low-dose methotrexate combination therapy

2017 ◽  
Vol 8 (1) ◽  
pp. 35 ◽  
Author(s):  
Caihong Qu ◽  
Ying Lu ◽  
Weimin Liu
Keyword(s):  
Bone Marrow ◽  
Combination Therapy ◽  
Digestive Tract ◽  
Low Dose ◽  
Pulmonary Infection ◽  
Bone Marrow Suppression ◽  
Dose Methotrexate

scholarly journals Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Pankti Jariwala ◽  
Vinay Kumar ◽  
Khyati Kothari ◽  
Sejal Thakkar ◽  
Dipak Dayabhai Umrigar
Keyword(s):  
Bone Marrow ◽  
Drug Interactions ◽  
Creatinine Level ◽  
Joint Pain ◽  
Low Dose ◽  
Skin Lesions ◽  
Bone Marrow Suppression ◽  
Intermittent Treatment ◽  
Self Medication ◽  
Dose Methotrexate

We describe two fatal cases of low dose methotrexate (MTX) toxicity in patients with psoriasis, emphasizing the factors that exacerbate MTX toxicity. The first patient was a 50-year-old male of psoriasis on intermittent treatment with MTX. After a treatment-free period of six months, he had self-medication of MTX along with analgesic for joint pain for one week which followed ulceration of the lesions, bone marrow suppression, and eventually death. The second patient was a 37-year-old male of psoriasis, who has taken MTX one week earlier without prior investigations. He had painful ulcerated skin lesions and bone marrow suppression. On investigations, he showed high creatinine level and atrophied, nonfunctioning right kidney on ultrasonography. In spite of dialysis, he succumbed to death. MTX is safe and effective if monitored properly, but inadvertent use may lead to even death also. Prior workup and proper counseling regarding the drug interactions as well as self-medication should be enforced.

scholarly journals Acute methotrexate toxicity in psoriasis

2019 ◽  
Vol 5 (3) ◽  
pp. 652
Author(s):  
Peram Karunakar ◽  
Venkateswara Rao Garimella ◽  
Chinmai Yerram ◽  
Anusha Gogula
Keyword(s):  
Bone Marrow ◽  
Plaque Psoriasis ◽  
Low Dose ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Psoriasis Patient ◽  
Bone Marrow Suppression ◽  
Chronic Plaque Psoriasis ◽  
Dose Methotrexate ◽  
Standard Treatment Guidelines

<p align="left">We describe two cases of low dose methotrexate (MTX) toxicity in patients with psoriasis. Patient was a 49-year-old male, known case of chronic plaque psoriasis from 10 years on and off. He was advised to take MTX 2.5 mg 2 days a week but patient took 2.5 mg twice daily (BD) for 6 continuous days following which he developed ulceration over psoriatic plaques and bone marrow suppression. MTX is safe and effective if adhered to standard treatment guidelines but inadverent use may lead to it’s toxicity.</p>

scholarly journals Severe bone marrow suppression following single-dose methotrexate treatment for ectopic pregnancy

2017 ◽  
Author(s):  
Betül Dündar ◽  
Burcu Dinçgez Çakmak ◽  
Gülten Özgen ◽  
Fatma Ketenci Gencer ◽  
Burcu Aydın Boyama
Keyword(s):  
Bone Marrow ◽  
Single Dose ◽  
Ectopic Pregnancy ◽  
Bone Marrow Suppression ◽  
Dose Methotrexate ◽  
Methotrexate Treatment

scholarly journals Clinical Characteristics and Efficacy of Adalimumab and Low-Dose Methotrexate Combination Therapy in Patients With Vogt–Koyanagi–Harada Disease

2022 ◽  
Vol 8 ◽  
Author(s):  
Tomona Hiyama ◽  
Yosuke Harada ◽  
Yoshiaki Kiuchi
Keyword(s):  
Side Effects ◽  
Combination Therapy ◽  
Immunosuppressive Therapy ◽  
Median Duration ◽  
Cyclosporine A ◽  
Clinical Characteristics ◽  
Low Dose ◽  
Dose Methotrexate ◽  
Therapy Methotrexate ◽  
Steroid Sparing

This retrospective study investigated the clinical characteristics and efficacy of adalimumab and low-dose methotrexate combination therapy in patients with Vogt–Koyanagi–Harada disease who were treated at Hiroshima University from February 2012 to May 2021. The patients' demographics, clinical features at administration of immunosuppressive therapy, steroid-sparing immunosuppressive therapy, side effects, and relapses were recorded. The efficacies of steroid-sparing immunosuppressive therapy (methotrexate, cyclosporine A, adalimumab, and adalimumab and methotrexate combination therapy) were analyzed. Among 62 patients, the median age at diagnosis was 47 years and the median duration of uveitis was 51 months. Systemic corticosteroid therapy was administered to 93.5% of patients (n = 58). Thirty-four patients (54.8%) were treated with steroid-sparing immunosuppressive therapy. Methotrexate and cyclosporine A were administered to 12 and 22 patients, respectively; relapse occurred in 50.0% and 22.7% of the patients, respectively. Discontinuation of cyclosporine A was required in 63.6% of patients because of side effects. Adalimumab was administered to 14 patients. Recurrence occurred in 11 patients, requiring methotrexate concomitantly. The mean dose of methotrexate at inflammatory quiescence after side effect-related dose decrease was 8.0 mg/week (0.13 mg/kg). The median duration of combination therapy without recurrence was 20 months. There were no serious adverse events during adalimumab therapy. A high relapse rate was observed in patients receiving methotrexate; a high rate of side effects requiring discontinuation was observed in patients receiving Cyclosporine A. Patients with late-stage Vogt–Koyanagi–Harada disease may achieve better control with adalimumab and methotrexate combination therapy.

scholarly journals Similar short-term clinical response to high-dose versus low-dose methotrexate in monotherapy and combination therapy in patients with rheumatoid arthritis

2017 ◽  
Vol 19 (1) ◽  
Author(s):  
Sytske Anne Bergstra ◽  
Cornelia F. Allaart ◽  
Rosaline van den Berg ◽  
Arvind Chopra ◽  
Nimmisha Govind ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Combination Therapy ◽  
Clinical Response ◽  
Low Dose ◽  
High Dose ◽  
Short Term ◽  
Dose Methotrexate

scholarly journals Low Transplant Mortality in Allogeneic Bone Marrow Transplantation for Acute Myeloid Leukemia: A Randomized Study of Low-Dose Cyclosporin Versus Low-Dose Cyclosporin and Low-Dose Methotrexate

Blood ◽  
1998 ◽  
Vol 91 (9) ◽  
pp. 3503-3508 ◽  
Author(s):  
P. Zikos ◽  
M.T. Van Lint ◽  
F. Frassoni ◽  
T. Lamparelli ◽  
F. Gualandi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Low Dose ◽  
Conditioning Regimen ◽  
Allogeneic Bone ◽  
End Points ◽  
Dose Methotrexate ◽  
Actuarial Risk ◽  
Acute Myeloid

Abstract Sixty patients undergoing allogeneic bone marrow transplant for acute myeloid leukemia (AML) in first remission (CR1; n = 49) or more advanced phase (n = 11) were entered in a prospective trial of graft-versus-host disease (GvHD) prophylaxis: low-dose cyclosporin A (IdCSA; 1 mg/kg/d from day −1 to +20 day; n = 28) or IdCSA plus low-dose methotrexate (IdMTX; 10 mg/m2 for day +1, 8 mg/m2 for days +3, +6, and +11; n = 32). Primary end points were acute GvHD (aGvHD) and transplant-related mortality (TRM); secondary end points were relapse and survival. The conditioning regimen consisted of cyclophosphamide (120 mg/kg) and fractionated total body irradiation (3.3 Gy/d for 3 consecutive days). The actuarial risk of developing aGvHD grade II-III was 61% for IdCSA alone and 34% for IdCSA + IdMTX (P = .02). The actuarial risk of TRM at 1 year was 11% versus 13%, respectively, and older patients (≧29 years) had higher TRM than younger patients (22% v 5%,P = .01). The age effect was significant in the IdCSA group (P = .04) but not in the IdCSA + IdMTX group (P = .1). The median follow-up is 4.4 years, with an overall actuarial survival of 78% for CR1 patients and 36% for patients with advanced disease. For patients in CR1 the outcome of the two regimens was as follows: survival 77% versus 80% (P = .6), relapse 20% versus 9% (P = .1), and TRM 13% versus 17% (P = .6). This study suggests that TRM can be reduced in AML patients undergoing allogeneic marrow transplants with a mild conditioning regimen and low-dose immunosuppression, and this translates in a 78% 5-year survival for CR1 patients. Beyond CR1 the major obstacle remains leukemia relapse, which is not prevented by low-dose in vivo immunosuppression.

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