Low effectiveness of methotrexate in the management of localised scleroderma (morphea) based on an ultrasound activity score

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dc.contributor.authorVera-Kellet, Cristian
dc.contributor.authorMeza-Romero, Rodrigo
dc.contributor.authorMoll-Manzur, Catherina
dc.contributor.authorRamirez-Cornejo, Cristian
dc.contributor.authorWortsman, Ximena
dc.date.accessioned2025-01-20T22:06:20Z
dc.date.available2025-01-20T22:06:20Z
dc.date.issued2021
dc.description.abstractBackground: The effectiveness of methotrexate (MTX), a first-line treatment for localised scleroderma (morphea), has not been assessed using colour Doppler ultrasonography (CDU). Objectives: We aimed to ultrasonographically monitor disease activity in patients with morphea treated with MTX, assessing its effectiveness using an Ultrasound Morphea Activity Score (US-MAS). Materials& Methods: Aretrospective cohort of 22 patients was studied between July 2014 and July 2019. The morphea of each patient, treated with MTX, was confirmed by histology and all patients had at least two CDU examinations. The US-MAS is based on published ultrasound signs of disease activity validated by histology. A weight-adjusted average MTX dose (mg/kg/wk) was used to standardize dosage, weight, and time between CDU examinations. The difference in US-MAS between two CDU examinations was determined. Statistical analyses includedWilcoxon and Fisher exact tests, the Spearman correlation coefficient, and risk ratios with 95% confidence intervals. To create two groups, we determined the median of the sample as the cut-off point for MTX dose (0.265 mg/kg/week). Significance was set at p <= 0.05; Results: In all cases, CDU examinations showed subclinical signs of activity beyond the visible lesional borders, either in the same or adjacent corporal segments. A negative correlation was found between the change in US-MAS andMTXdose (Spearman coefficient, -0.45; p = 0.035). The group dosed at >= 0.265 mg/kg/wk showed a non-significant change in US-MAS (2-point decrease). No case became inactive. Conclusion: MTX is a treatment with a low effectiveness for morphea, causing only slight decreases in ultrasound activity at higher doses.
dc.fuente.origenWOS
dc.identifier.doi10.1684/ejd.2021.4189
dc.identifier.eissn1952-4013
dc.identifier.issn1167-1122
dc.identifier.urihttps://doi.org/10.1684/ejd.2021.4189
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94204
dc.identifier.wosidWOS:001072917300001
dc.issue.numero6
dc.language.isoen
dc.pagina.final821
dc.pagina.inicio813
dc.revistaEuropean journal of dermatology
dc.rightsacceso restringido
dc.subjectmorphea
dc.subjectlocalized scleroderma
dc.subjectmethotrexate
dc.subjectmorphea treatment
dc.subjectmorphea ultrasound
dc.subjectdermatologic ultrasound
dc.subjectskin ultrasound
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleLow effectiveness of methotrexate in the management of localised scleroderma (morphea) based on an ultrasound activity score
dc.typeartículo
dc.volumen31
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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