Fabbri L, Caramori G, Cosma P, Ciaccia A
Institute of Infectious and Respiratory Diseases, University of Ferrara, Italy.
Monaldi Arch Chest Dis. 1996 Apr;51(2):130-7.
Methotrexate should not be prescribed to every systemic glucocorticoid-dependent asthmatic. In fact, while methotrexate may be advantageous in selected patients, every attempt to control asthma with regular anti-asthma agents should be made. Most studies on the effects of methotrexate in the treatment of systemic glucocorticoid-dependent asthmatics include small numbers of patients and are all of relatively short duration. Thus, large long-term multicentre trials are urgently needed. In these studies, a uniform accepted definition of systemic glucocorticoid-dependent asthmatics should be used. For the time being, we reinforce the recommendation of the NHLBI/ WHO panel that methotrexate and other systemic glucocorticoid sparing drugs should be considered experimental medications, and used only in selected patients under the supervision of an asthma specialist with previous experimental experience.
甲氨蝶呤不应开给每一位全身性糖皮质激素依赖型哮喘患者。事实上，虽然甲氨蝶呤可能对某些特定患者有益，但应尝试先用常规抗哮喘药物来控制哮喘。大多数关于甲氨蝶呤治疗全身性糖皮质激素依赖型哮喘患者效果的研究纳入的患者数量较少，且持续时间都相对较短。因此，迫切需要开展大规模的长期多中心试验。在这些研究中，应采用统一公认的全身性糖皮质激素依赖型哮喘患者的定义。目前，我们强化美国国立心肺血液研究所/世界卫生组织专家小组的建议，即甲氨蝶呤和其他减少全身性糖皮质激素用量的药物应被视为试验性药物，仅在有试验经验的哮喘专科医生的监督下用于特定患者。
