ArticleSarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG2020
Methotrexate in sarcoidosis: hematologic and hepatic toxicity encountered in a large cohort over a six year period.
Article in Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 25 citations in OpenAlex.
- Sarcoidosis: A Clinical Trials Perspective.Pulmonary therapy · 2026Review
- Cirrhosis Risk in Sarcoidosis Without Documented Hepatic Involvement-A Large Nationwide Population-Based Cohort Study.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- A paradigm shift in corticosteroid therapy for sarcoidosis: a World Association of Sarcoidosis and Other Granulomatous Disorders Position Paper, endorsed by the Americas Association of Sarcoidosis and Other Granulomatous Disorders.The Lancet. Respiratory medicine · 2026Review
- Neuropsychiatric manifestations of sarcoidosis.Annals of medicine · 2025Review
- Neurosarcoidosis: a review from diagnosis and future perspectives.EClinicalMedicine · 2025Review
- Sarcoidosis: molecular mechanisms and therapeutic strategies.Molecular biomedicine · 2025Review
- [Position paper of the Austrian Society for Rheumatology and the Austrian Society for Pneumology on the diagnosis and treatment of sarcoidosis 2024].Wiener klinische Wochenschrift · 2024Article
- Gastric sarcoidosis diagnosed with endoscopic ultrasound.Clinical case reports · 2024Article
- The Protective Effect of Roflumilast Against Acute Hepatotoxicity Caused by Methotrexate in Wistar Rats: In vivo Evaluation.Drug design, development and therapy · 2024Article
- A Rapid Method for Determination of Serum Methotrexate Using Ultra-High-Performance Liquid Chromatography-Tandem Mass Spectrometry and Its Application in Therapeutic Drug Monitoring.Journal of laboratory physicians · 2023Article
- Comorbidities of sarcoidosis.Annals of medicine · 2022Review
- Controversies in the Treatment of Cardiac Sarcoidosis.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2022Article
- The impact of demographic disparities in the presentation of sarcoidosis: A multicenter prospective study.Respiratory medicine · 2021Article
- Efficacy and Tolerability of Methotrexate and Methylprednisolone in a Comparative Assessment of the Primary and Long-Term Outcomes in Patients with Pulmonary Sarcoidosis.Diagnostics (Basel, Switzerland) · 2021Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMethotrexate (MTX) is a second line agent for treatment of sarcoidosis. Its long term safety and efficacy in sarcoidosis remains unclear.
methodsThis was a retrospective review of patients seen at the University of Cincinnati Sarcoidosis Clinic over a six year period. For each visit, complete blood count, liver function testing, and dosing and outcome of MTX was noted. For efficacy, we compared the outcome of therapy of a matching subgroup of patients treated with either MTX or infliximab for one year and results scored as improved, stable, or worse based on response of the target organ.
resultsOver six years, 1606 sarcoidosis patients were seen with a total of 13,576 clinical visits. During the study period, 607 patients (38% of total) were receiving MTX and had available blood work. Moderate elevation of alanine aminotransferase (ALT) (>3 times upper limit normal) was seen in nine (1.6%) patients. White blood count of <1500 cells per cu mm was seen in one patient. At six months, over half of the 44 patients initiated on infliximab and with at least six months of follow-up were better, while only 23% of the 44 of a matched subset of MTX treated patients were better (Chi square=10.566, p=0.0143). At the 12 month assessment, the infliximab treated patients were still more likely to be better than those treated with MTX (Chi square=10.033, p=0.0183). Only 23% of those treated with MTX were worse at twelve months.
conclusionIn our study, MTX therapy was associated with very few hepatic or hematologic complications. MTX was less likely than infliximab to improve clinical status. However, only 20% were worse after one year of MTX.
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