2023共识指南：甲氨蝶呤治疗儿童炎症性皮肤病

真Check for updatesReceived:19 December 2022 Accepted:26 March 2023D0:10.1111/pde.15327Pediatric,PEDRA ORIGINALARTICLEDermatologyWILEYMethotrexate for inflammatory skin disease in pediatricpatients:Consensus treatment guidelinesElaine C.Siegfried MD12 Lisa M.Arkin MD3 Yvonne E.Chiu MDAdelaide A.Hebert MD5 Jeffrey P.Callen MD5 Leslie Castelo-Soccio MD7.8Dominic O.Co MD3 Kelly M.Cordoro MD Megan L.Curran MD10Austin M.Dalrymple MD12 Carsten Flohr MD11 Ken B.Gordon MD4Diane Hanna DNP12 Alan D.Irvine MD13 Susan Kim MDA.Yasmine Kirkorian MD14.15 Irene Lara-Corrales MD16 Jill Lindstrom MD17Amy S.Paller MD18 Melissa Reyes MD19 Wendy Smith Begolka MBS20Wynnis L.Tom MD21.22 Abby S.Van Voorhees MD23Ruth Ann Vleugels MD24.25 Lara Wine Lee MD26 Olivia M.T.Davies MD4Heather A.Brandling-Bennett MD27.28CorrespondenceElaine C.Siegfried,Saint Louis UniversityAbstractSchool of Medicine,St.Louis,Mo.USA.Methotrexate(MTX)is a readily accessible drug.first used in 1948 and employed forEmail:elaine.siegfried@health.slu.edua wide variety of indications since then.However,despite widespread off-label use,Funding informationFDA labeling does not include approved indications for the use of MTX for manyNational Eczema Association:NationalPsoriasis Foundation;Pediatric Dermatologyinflammatory skin diseases in pediatric patients,including morphea,psoriasis,atopicResearch Alliancedermatitis,and alopecia areata,among others.Without published treatment guide-lines,some clinicians may be hesitant to use MTX off-label,or uncomfortable pre-scribing MTX in this population.To address this unmet need,an expert consensuscommittee was convened to develop evidence-and consensus-based guidelines foruse of MTX to treat pediatric inflammatory skin disease.Clinicians with experienceand expertise in clinical research,drug development,and treating inflammatory skindisease in pediatric patients with MTX were recruited.Five committees were createdbased on major topic areas:(1)indications and contraindications,(2)dosing,(3)inter-actions with immunizations and medications.(4)adverse effects (potential for andmanagement of),and(5)monitoring needs.Pertinent questions were generated andaddressed by the relevant committee.The entire group participated in a modifiedDelphi process to establish agreement on recommendations for each question.Thecommittee developed 46 evidence-and consensus-based recommendations,eachThe opinions and assertions expressed herein are those of thehors and do not reflect the official poicyor positionof the U.S.Food and DrugAdministrationDisclaimer:This publication has been reviewed by FDA and determined not to be consistent with the Agency's views or policies.It reflects only the views and opinions of the authors.5a992g.12.This is an open access artide under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License,which permits use and distribution in anymedium,provided the original work is properly cited,the use is non-commercial and no modifications or adapt