New insights from Vietnam on the effectiveness of methotrexate in treating prurigo nodularis: An interventional study with a control group
The effectiveness of methotrexate in treating prurigo nodularis
Keywords:
Desloratadine, methotrexate, prurigo nodularis, Pruritus Numeric Rating ScaleAbstract
Background  Prurigo nodularis is a chronic inflammatory skin condition marked by firm nodules and severe itching, significantly impairing quality of life. Methotrexate (MTX) has demonstrated efficacy in alleviating itching and reducing skin lesions in difficult and recurrent cases, with sustained benefits and good tolerability.  Objective To evaluate the efficacy of MTX in treating prurigo nodularis in Vietnam.  Methods This interventional study included 33 patients in the MTX group, receiving weekly methotrexate (10 mg), daily desloratadine (5 mg), topical corticosteroids, and moisturizers. A control group received the same treatment, excluding MTX. Outcomes were assessed at 4, 8, and 12 weeks.  Results Before treatment, the MTX group's mean scores for pruritus severity (Pruritus Numeric Rating Scale - PNRS), number of nodules/lesions, and active lesion count were 3.61±0.79, 58.27±34.38, and 33.0±25.69, respectively. After 12 weeks, these scores significantly decreased to 1.52±1.03, 22.45±14.49, and 11.32±10.74 (P<0.001). The MTX group showed greater itch reduction than the control group at week 4 (P=0.006). The reduction in the number of active lesions and nodules/lesions in the MTX group was statistically significant compared to the control group at all follow-up points (P<0.05). Adverse effects included gastrointestinal symptoms (6.1%) and one infection (3.0%).  Conclusion  MTX is effective and well-tolerated for treating prurigo nodularis, emphasizing its potential in clinical management. ÂReferences
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