Both methotrexate and cyclosporin may be leveraged to treat severe atopic dermatitis in children. But is one treatment more effective than the other? Researchers attempted to answer this question in the TREAT study. According to reporting by Healio, 103 pediatric patients (ages 2-16) enrolled in this study. The participants had severe atopic dermatitis that was difficult to treat. During the trial, participants were split into two groups:
- Methotrexate: In this group, participants received orally administered methotrexate at 0.1mg/kg to start and 0.4mg/kg a week moving forward. This group also took 1mg folic acid each day.
- Cyclosporin: In this group, participants received 4mg/kg cyclosporin daily and had the chance, if they wanted, to increase their dose to 5mg/kg at week 12 of the study.
Research findings published in the British Journal of Dermatology found that both methotrexate and cyclosporin conferred benefits for users. Methotrexate significantly reduced atopic dermatitis flares. Both treatments improved overall quality-of-life.
While both methods were effective, they also acted in different ways. For example, cyclosporin was quicker acting, meaning that participants received relief from symptoms faster. However, methotrexate was more effective long-term and had a more sustained response. As such, the researchers note, methotrexate is considered a slightly stronger long-term option. Methotrexate also showed more benefits in disease control and price. Taken together, these factors all highlight that methotrexate may be better for users than cyclosporin. However, not every person is the same – nor does their body respond the same way to treatment. If you are choosing between these therapies, please speak with your care team for personalized recommendations.
Methotrexate and cyclosporin were both relatively well-tolerated, though severe adverse reactions occurred in a small percentage of each treatment arm.
About Severe Atopic Dermatitis
You may know atopic dermatitis under a different name: eczema. This chronic inflammatory skin condition causes dry, itchy skin that weeps when scratched. People with severe atopic dermatitis are often extremely itchy. However, over-scratching can cause the skin to become more prone to viral, fungal, or bacterial infections.
Doctors believe that a blend of genetic and environmental factors cause severe atopic dermatitis. This skin condition is more common in people who live in drier areas; those affected also tend to have other allergic conditions. Severe atopic dermatitis may worsen with exposure to dyes or fragrances, rough materials on the skin, stress, cold and dry area, infections, or chemical irritation.
For tips on how to best care for severe atopic dermatitis, check out this helpful resource from the American Academy of Dermatology Association.
