Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
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
Show Affiliations
Authors Affiliations
  1. 1. Department Of Dermatology, Amsterdam Umc, University Of Amsterdam, Amsterdam Public Health, Infection And Immunity, Amsterdam, Netherlands
  2. 2. Department Of Dermatology, Olvg, Amsterdam, Netherlands
  3. 3. Department Of Dermatology, University Of Pecs, Medical School, Venerology And Oncodermatology, Pecs, Hungary
  4. 4. Department Of Dermatology, Aarhus University Hospital, Aarhus, Denmark
  5. 5. The Dermatology Centre, Salford Royal Nhs Foundation Trust, The Manchester Nihr Biomedical Research Centre, United Kingdom
  6. 6. Centro Dermatologico Schejtman, Provincia de Buenos Aires, Argentina
  7. 7. Department Of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
  8. 8. Center For Research And Training In Skin Diseases And Leprosy, Tehran University Of Medical Sciences, Tehran, Iran
  9. 9. Apollo Hospital, Telangana, Secunderabad, India
  10. 10. Waikato District Health Board, University Of Auckland, Auckland, New Zealand
  11. 11. Hospital Das Clinicas Da Universidade Federal De Minas Gerais, Belo Horizonte, Brazil
  12. 12. Military Teaching Hospital Begin, Saint Mande, France
  13. 13. School Of Medicine, University Of Split, University Hospital Centre Split, Croatia
  14. 14. Department Of Dermatology And Venerology, Akdeniz University, School Of Medicine, Antalya, Turkey
  15. 15. Department Of Dermatology, University Medical Center Groningen, University Of Groningen, Groningen, Netherlands
  16. 16. Department Of Dermatology, Teaching Hospital Kaposvar, Kaposvar, Hungary
  17. 17. University Of Costa Rica, Hospital Nacional De Ninos, San Jose Province San Pedro Montes de Oca, Costa Rica
  18. 18. Psoriasis Treatment Wards, Stockholm, Sweden
  19. 19. Dermatologist Hospital Universitario Austral, Buenos Aires, Argentina
  20. 20. Department Of Dermatology, Hospital Universitario Germans Trias I Pujol, Universidad Autonoma De Barcelona, Barcelona, Spain
  21. 21. Dermatology Service Of La Samaritana University Hospital, Bogota, Colombia
  22. 22. Pontificia Universidad Javeriana, National University Of Colombia, Bogota, Colombia
  23. 23. Proderma, Clinica De La Piel, San Juan, Argentina
  24. 24. Department Of Immunology And Clinical Allergology, Lyon Sud Hospital, Saint-Genis-Laval, France
  25. 25. Department Of Dermatology, Radboudumc Nijmegen, Nijmegen, Netherlands
  26. 26. Centro Dermatologico Dr. Ladislao De La Pascua, Mexico City, Mexico
  27. 27. Department Of Dermatology And Skin Science, University Of British Columbia, Vancouver, BC, Canada
  28. 28. Instituto De Rehabilitacion Psicofisica, Irep, Buenos Aires, Argentina
  29. 29. Clinica Dermacross, Santiago, Chile
  30. 30. Department Of Dermatology, Lausanne University Hospital Chuv, Lausanne, Switzerland
  31. 31. Department Of Dermatology And Venereology, University Hospital Centre Zagreb, School Of Medicine, University Of Zagreb, Croatia
  32. 32. Hospices Civils De Lyon, Hopital E. Herriot, Service De Dermatologie, Lyon, France
  33. 33. Radboud University Medical Center, Nijmegen, Netherlands
  34. 34. Department Of Dermatology, Cha Bundang Medical Center, Cha University College Of Medicine, Seongnam, South Korea
  35. 35. Damietta Faculty Of Medicine, Al-Azhar University, Cairo, Egypt
  36. 36. Department Of Dermatology, University Hospital Of Geneva, Geneva, Switzerland
  37. 37. Service De Dermatologie, Hopital Victor Dupouy, Argenteuil, France
  38. 38. Department Of Medical Sciences, Uppsala University, Uppsala, Sweden
  39. 39. Hospital Vargas De Caracas, Venezuela
  40. 40. Dermatology Department, Hospital De La Santa Creu I Sant Pau, Universitat Autonoma De Barcelona, Barcelona, Spain
  41. 41. Hopital Erasme, Universite Libre De Bruxelles, Anderlecht, Belgium
  42. 42. Santiago de Surco, Peru
  43. 43. Molecular Dermatology Research Center, Shiraz University Of Medical Sciences, Shiraz, Iran
  44. 44. Department Of Dermatology University Of Chile, Centro Internacional De Estudios Clinicos, Probity Medical Research, Santiago, Chile
  45. 45. Department Of Dermatology, Hospital Universitario Virgen De Las Nieves, Granada, Spain
  46. 46. Hospital De Clinicas, Universidad De La Republica Montevideo, Uruguay
  47. 47. Department Of Clinical Dermatology, Irccs Istituto Ortopedico Galeazzi, Milan, Italy
  48. 48. Department Of Biomedical, Surgical And Dental Sciences, University Of Milan, Milan, Italy
  49. 49. Naftalan, Special Hospital For Medical Rehabilitation, Zagreb, Croatia
  50. 50. Soarpso, Argentina
  51. 51. Servicio De Dermatologia, Hospital Universitario De Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain
  52. 52. Hamad Medical Corporation, Qatar
  53. 53. National Skin Centre, Singapore
  54. 54. Heilig Hartziekenhuis, Leuven, Belgium
  55. 55. Service De Dermatologie, Hopital Cheiko, Djibouti
  56. 56. Dermatology Department, Complexo Hospitalario Universitario De Vigo, Vigo, Spain
  57. 57. Department Of Dermatology And Allergology, Albert Szent-Gyorgyi Health Center, Department Of Dermatology And Allergology, Szeged, Hungary
  58. 58. Department Of Dermatovenerology, University Hospital Clinic, Rijeka, Croatia
  59. 59. Brunswick Dermatology Center, Fredericton, NB, Canada
  60. 60. Dalhousie University, Halifax, NS, Canada
  61. 61. Probity Medical Research, Waterloo, ON, Canada
  62. 62. Department Of Dermatology, Brugmann University Hospital, Brussels, Belgium
  63. 63. Icahn School Of Medicine At Mount Sinai, New York, NY, United States
  64. 64. Department Of Dermatology, Royal Melbourne Hospital, Melbourne, VIC, Australia
  65. 65. University Of Sydney, Westmead Hospital, Sydney, NSW, Australia
  66. 66. Department Of Dermatology, Division Of Infection & Immunity, Cardiff University, Cardiff, United Kingdom
  67. 67. Department Of Dermatology And Allergy, University Hospital, Lmu Munich, Munich, Germany
  68. 68. Hospital Do Servidor Publico Estadual De Sao Paulo, Brazil
  69. 69. Department Of Dermatology, General Hospital Valencia, Valencia, Spain
  70. 70. Department Of Dermatology, MacKay Memorial Hospital, Taipei City, Taiwan
  71. 71. Universidad Militar, Colpsor, Colombia
  72. 72. Department Of Dermatology, University Hospital Of Zurich, Zurich, Switzerland
  73. 73. Department Of Dermatology, Radboudumc, Nijmegen, Netherlands
  74. 74. Department Of Dermatology And Venereal Diseases, University Medical Centre Maribor, Maribor, Slovenia
  75. 75. University Of Calgary, Calgary, AB, Canada
  76. 76. Translational Research In Inflammatory Skin Diseases, Institute For Health Services Research In Dermatology And Nursing, University Medical Center Hamburg-Eppendorf, Germany
  77. 77. Fremantle Dermatology, WA, Australia
  78. 78. Kyiv Medical University, Medical Centre Khobzei Clinic, Kyiv, Ukraine
  79. 79. Department Of Dermatology, University Hospital Of Basel, Basel, Switzerland
  80. 80. Department Of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University Of Rijeka, Rijeka, Croatia
  81. 81. Department Of Dermatology, Hopital Henri Mondor, Creteil, France
  82. 82. University Paris Est Creteil, Creteil, France
  83. 83. Department Of Dermatology, Hopitaux Universitaires Henri Mondor, Upec, Creteil, France
  84. 84. Department Of Dermatology, University Hospital Of Brest, Department Of Dermatology, Brest, France
  85. 85. Jawaharlal Institute Of Postgraduate Medical Education And Research, Pondicherry, India
  86. 86. European Academy Of Dermatology And Venereology Member, Romania
  87. 87. Bergman Clinics, Dermatology, Haarlem and Amsterdam, Netherlands
  88. 88. Department Of Dermatology And Allergy, Copenhagen University Hospital-Herlev And Gentofte, Copenhagen, Denmark
  89. 89. Department Of Clinical Medicine, University Of Copenhagen, Copenhagen, Denmark
  90. 90. University Of The Philippines, College Of Medicine, Philippine General Hospital, Manila, Philippines
  91. 91. Special Hospital For Medical Rehabilitation, Naftalan, Azerbaijan
  92. 92. Department Of Dermatology, Hospital De La Santa Creu I Sant Pau, Universitat Autonoma De Barcelona, School Of Medicine, Barcelona, Spain
  93. 93. Hospital Militar Central Universidad Militar Nueva Granada, Bogota, Colombia
  94. 94. All India Institute Of Medical Sciences, New Delhi, India
  95. 95. University Of Toronto, Toronto, ON, Canada
  96. 96. Faculty Of Medicine, Ain Shams University, Cairo, Egypt
  97. 97. Department Of Dermatology, Medical Unversity Of Warsaw, Warsaw, Poland
  98. 98. Zbc Multicare, Hilversum, Netherlands
  99. 99. Universidad El Bosque, Bogota, Colombia
  100. 100. Dermatology Department, Hospital Universitario De La Princesa, Madrid, Spain
  101. 101. Department Of Dermatology, Coimbra University Hospital, Faculty Of Medicine, University Of Coimbra, Coimbra, Portugal
  102. 102. Universidad De Antioquia, Centro De Investigaciones Dermatologicas Ciderm, Medellin, Colombia
  103. 103. Hospital Aleman And Hospital Ramos Mejia, Buenos Aires, Argentina
  104. 104. Federal University, Bahia, Brazil
  105. 105. Department Of Dermatology, Radboud University Medical Centre, Nijmegen, Netherlands
  106. 106. Department Of Dermatovenergology, Referral Center For Psoriasis, Chc Rijeka, University Of Rijeka, Rijeka, Croatia
  107. 107. Waikato Clinical School, School Of Medicine, University Of Auckland, Auckland, New Zealand
  108. 108. National Institute Of Geriatrics, Rheumatology And Rehabilitation, Warsaw, Poland
  109. 109. Department Of Medicine, University Of Manitoba, Winnipeg, MB, Canada
  110. 110. Department Of Dermatology, Hospital Del Mar, Barcelona, Spain
  111. 111. Department Of Dermatology, Erasmus Medical Center, Rotterdam, Netherlands
  112. 112. Department Of Dermatology, Tehran University Of Medical Sciences, Tehran, Iran
  113. 113. Clinic Of Infectious Diseases And Dermatovenereology, Centre Of Dermatovenereology, Vilnius University, Vilnius, Lithuania
  114. 114. SKiN Centre For Dermatology And Probity Medical Research, Queen's University, Peterborough, ON, Canada
  115. 115. Osijek University Hospital, Faculty Of Medicine, Osijek, Croatia
  116. 116. School Of Medicine, The Second Affiliated Hospital Of Zhejiang University, Hangzhou, China
  117. 117. Universidad Autonoma De Nuevo Leon, San Nicolas de los Garza, Mexico
  118. 118. Department Of Dermatology, Hospital Sagrat Cor, Barcelona, Spain
  119. 119. Golden Towers Medical Centre, Tunis, Tunisia
  120. 120. Department Of Dermatology, Inselspital, Bern University Hospital, University Of Bern, Bern, Switzerland
  121. 121. Universites De Tours Et Nantes, Creteil, France
  122. 122. Skin Research Center, Tehran, Iran
  123. 123. Dermatology Department, Hospital Unuversitario Infanta Leonor, Madrid, Spain
  124. 124. Department Of Dermatology, University Of Sydney, Westmead Hospital, Westmead, NSW, Australia
  125. 125. National University Of Colombia, Bogata, Colombia
  126. 126. Section Of Dermatology And Venereology, University Of Verona, Verona, Italy
  127. 127. University Of Alberta, Edmonton, AB, Canada
  128. 128. Department Of Dermatology, Clinic Hietzing, Vienna, Austria
  129. 129. Hospital Aleman, Buenos Aires, Argentina
  130. 130. Departament Of Dermatology, Hospital Federal Dos Servidores Do Estado, Rio de Janeiro, Brazil
  131. 131. Dermatology Department, Centro Hospitalar Vn Gaia, Portugal
  132. 132. Department Of Dermatology, Venereology, And Dermatooncology, Semmelweis University, Budapest, Hungary
  133. 133. Department Of Dermatovenereology, Faculty Of Medicine, Charles University, Prague, Czech Republic
  134. 134. University Of Brescia, Brescia, Italy
  135. 135. Department Of Dermatology Ucl St-Luc, Brussels, Belgium
  136. 136. Department Of Dermatology, Hospital Das Clinicas, University Of Sao Paulo, Sao Paulo, Brazil
  137. 137. Department Of Dermatology And Allergology, Albert Szent-Gyorgyi Medical School, University Of Szeged, Szeged, Hungary
  138. 138. Department Of Dermatology And Venereology, University Hospital Center Zagreb, School Of Medicine, University Of Zagreb, Zagreb, Croatia
  139. 139. Dermatrials Research Inc, Hamilton, ON, Canada
  140. 140. Hospital Reina Sofia, Tudela, Spain
  141. 141. Hospital LEsperit Sant, Santa Coloma de Gramenet, Spain
  142. 142. Department Of Dermatology, Ryhov County Hospital, Jonkoping, Sweden
  143. 143. Department Of Dermatology, Venereology & Leprology, Chandigarh, India
  144. 144. St John's Institute Of Dermatology, Guy's And St Thomas' Nhs Foundation Trust, King's College London, London, United Kingdom
  145. 145. Gsl Medical College, Andhra Pradesh, Rajahmundry, India
  146. 146. Dermatology Department, University Hospital Miguel Servet, Zaragoza, Spain
  147. 147. Aragon Psychodermatology Research Group, Zaragoza, Spain
  148. 148. Center For Research And Training In Skin Diseases And Leprosy, Tehran, Iran
  149. 149. Department Of Dermatology, Unit Pediatric Dermatology, Skin Research Group, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
  150. 150. Secretaria Municipal De Saude De Natal, Brazil
  151. 151. Clinical School Johor Bahru, Monash University Malaysia, Subang Jaya, Malaysia
  152. 152. Department Of Dermatology, F.D. Roosevelt Hospital, Banska Bystrica, Slovakia
  153. 153. Dermatology Unit, Department Of Medicine, Faculty Of Clinical Sciences, University Of Lagos, Lagos, Nigeria
  154. 154. Consultorios Integrados Rosio, Hospital I Carrasco Rosario, Argentina
  155. 155. Departments Of Dermatology, Biochemistry & Molecular Biology, Center Of Applied Nanomedicine, National Cheng Kung University Hospital, College Of Medicine, National Cheng Kung University, Tainan, Taiwan
  156. 156. Helsinki University Hospital, Skin And Allergy Hospital, Helsinki, Finland
  157. 157. Jessenius Faculty Of Medicine, Martin, Comenius University, Bratislava, Slovakia
  158. 158. Faculty Of Medicine, Universidad Del Desarrollo Santiago De Chile, Santiago, Chile
  159. 159. Hudpoliklinikken I Namsos, Norway
  160. 160. Department Of Dermatology, Centro Hospitalar Universitario Do Porto, Porto, Portugal
  161. 161. First Affiliated Hospital Of Kunming Medical University, Kunming, China
  162. 162. Akad.N.Kipshidze Central University Clinic, Tbilisi, Georgia
  163. 163. School Of Medical Sciences And Research, Sharda University, Uttar Pradesh, India
  164. 164. Queen Elizabeth Hospital, Woodville, SA, Australia
  165. 165. Faculty Of Medicine, Memorial University Of Newfoundland And Labrador, Newfoundland and Labrador, St. John's, Canada

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.