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[Methotrexate use in patients with systemic lupus erythematosus].

BACKGROUND
In the past ten years, methotrexate (MTX) has appeared as an alternative for the treatment of systemic lupus erythematosus (SLE).


AIM
To evaluate the use of MTX and the results of treatment in a group of patients with SLE.


PATIENTS AND METHODS
Retrospective review of 426 files of patients with SLE. Of these, all patients treated with MTX were selected. A review protocol was designed, stating sex, age, time of disease evolution, previous treatment, MTX prescription, doses, effectiveness and side effects.


RESULTS
Seven patients were selected. All were women, with an age range of 26 to 62 years old and with 5 to 34 years of disease evolution. Previous treatment with non steroidal anti-inflammatory drugs, steroids, hydroxychloroquine and azathioprine ranged from 6 to 631 months (average=147.3). Persistent joint and/or skin manifestations were the main cause for the use of MTX. The dose ranged from 75 to 15 mg and the treatment lapse from 6 to 106 months. It was effective in all patients, allowing a reduction in prednisone doses. Two patients experienced a rise in serum transaminases and one had gastric intolerance, that required treatment discontinuation.


CONCLUSIONS
MTX is rarely used in SLE. Its main prescription and effectiveness is in joint and skin manifestations, allowing to decrease steroid doses. However, side effects are frequent.