فائدة الميثوتريكسات كمعالجة مساعدة للبريدنيزولون في معالجة مرضى الفقاع الشائع متوسط الشدة

Background& Objective: pemphigus vulgaris is a life threatening relapsing disease, the first line in its treatment is systemic steroids, and due to the high rate of side effects caused by systemic steroids in pemphigus vulgaris patients, some immunosuppressant drugs have been introduced as an adjuvant steroid sparing agents, and one of these immunosuppressants is methotrexate, and in spite of the lack of its use in pemphigus vulgaris, a few studies have shown an encouraging results of its use, and have advised to carry out more studies about it as an immunosuppressant which has been omitted from usage in pemphigus vulgaris for a long time. Purpse:to study the advantage of adding low dose of methotrexate as an adjuvant therapy to prednisolone in moderate pemphigus vulgaris, and to compare the response with the response of prednisolone alone. Materials & Methods: 28 moderate pemphigus vulgaris patients have been studied, from the patients of the dermatology university hospital during the period between 29/8/2009 -29/8/2010 then the patients were followed-up for 18 months, they have been divided into 2 groups. The first: were treated with prednisolone plus methotrexate (13 patients ), the second : were treated with prednisolone alone (15 patients ). the response has been Monitored and studied and after the control of the disease the dose of prednisolone was reduced gradually ,till it was stopped, and patients were observed for relapse through the following year and a half. Results: no significant difference statistically was observed between the two groups in the terms of achieving a good response (good response means by definition: the ceasing of the appearance of new lesions plus the recovery of 80% of established lesions), but the adding of methotrexate decreased the time in which the dermal lesions started to heal in a statically significant differance, as well it contributed in decreasing the relapse rate in a significant difference statistically with a limited side effects. Conclusion: methotrexate can be used as an adjuvant therapy in pemphigus vulgaris patients to reduce the relapse rate in those patients after desease control