Patient reported side-effects of prednisone and methotrexate in a real-world sarcoidosis population

• Published in: Chronic respiratory disease Vol. 18; p. 14799731211031935
• Main Authors: Kahlmann, Vivienne, Moor, Catharina C, Veltkamp, Marcel, Wijsenbeek, Marlies S
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 2021; Sage Publications Ltd
• Subjects: Chemotherapy; Methotrexate; Patients; Quality of life; Research Letter; Sarcoidosis; Side effects; Steroids; treatment; methotrexate; side-effects; Sarcoidosis; quality of life; prednisone
• ISSN: 1479-9731; 1479-9723; 1479-9731
• 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% (p = 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.