Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
ILD Center of Excellence, Department of Pulmonology, 6028St. Antonius Hospital, Nieuwegein, The Netherlands.
Chron Respir Dis. 2021 Jan-Dec;18:14799731211031935. doi: 10.1177/14799731211031935.
Currently prednisone is the first-line pharmacological treatment option for pulmonary sarcoidosis. Methotrexate is used as second-line therapy and seems to have fewer side-effects. No prospective comparative studies of first-line treatment with methotrexate exist. In this study, we evaluated patient reported presence and bothersomeness of side-effects of prednisone and methotrexate in a sarcoidosis population to guide the design of a larger prospective study. During a yearly patient information meeting 67 patients completed a questionnaire on medication use; 11 patients never used prednisone or methotrexate and were excluded from further analysis. Of the remaining 56 patients, 89% used prednisone and 70% methotrexate (present or former). Significantly more side-effects were reported for prednisone than for methotrexate, 78% versus 49% ( = 0.006). In conclusion, methotrexate seems to have fewer and less bothersome side-effects than prednisone. These findings need to be confirmed in a prospective study.
目前，泼尼松是治疗肺结节病的一线药物选择。甲氨蝶呤被用作二线治疗药物，其副作用似乎较少。目前尚无关于甲氨蝶呤一线治疗的前瞻性比较研究。在这项研究中，我们评估了结节病患者报告的泼尼松和甲氨蝶呤的副作用的存在和困扰程度，以指导更大的前瞻性研究的设计。在每年的一次患者信息会议上，67 名患者完成了一份关于药物使用的问卷；11 名从未使用过泼尼松或甲氨蝶呤的患者被排除在进一步分析之外。在其余的 56 名患者中，89%使用了泼尼松，70%使用了甲氨蝶呤（现在或曾经使用过）。与甲氨蝶呤相比，报告的泼尼松副作用明显更多，分别为 78%和 49%（=0.006）。总之，甲氨蝶呤的副作用似乎比泼尼松少，且不那么困扰。这些发现需要在一项前瞻性研究中得到证实。
