International eDelphi study to reach consensus on the methotrexate dosing regimen in patients with psoriasis

van Huizen, Astrid M., Menting, Stef P., Gyulai, Rolland, Iversen, Lars, van der Kraaij, Gayle E., Middelkamp-Hup, Maritza A., Warren, Richard B., Spuls, Phyllis I., Schejtman, Adrián A., Egeberg, Alexander, Firooz, Alireza, Kumar, Alur S., Oakley, Amanda, Foulkes, Amy, Ramos, Andrea Machado Coelho, Fougerousse, Anne-Claire, Čarija, Antoanela, Akman-Karakaş, Ayse, Horváth, Barbara, Fábos, Béata, Matlock, Benjamin Hidalgo, Claréus, Birgitta Wilson, Castro, Carla, Ferrándiz, Carlos, Correa, Carolina Cortés, Marchesi, Carolina, Goujon, Catherine, Gonzalez, Cesar, Maldonado-García, César, Hong, Chih-ho, Griffiths, Christopher E.M., Vestergaard, Christian, Echeverría, Christina Mariela, de la Cruz, Claudia, Conrad, Curdin, Törőcsik, Dániel, Drvar, Daniela Ledić, Balak, Deepak, Jullien, Denis, Appelen, Diebrecht, Kim, Dong Hyun, de Jong, Elke M.G.J., El Gamal, Emad, Laffitte, Emmanuel, Mahé, Emmanuel, Sonkoly, Enikö, Colombo, Erika Páez, Vilarrasa, Eva, Willaert, Fabienne, Novoa, Farah D., Handjani, Farhad, Valenzuela, Fernando, Vílchez-Márquez, Francisco, Gonzalez, Gabriela Otero, Krisztián, Gáspár, Damiani, Giovanni, Krnjević-Pezić, Gordana, Pellerano, Graciela, Carretero, Gregorio, Hunter, Hamish J. A., Riad, Hassan, Oon, Hazel H., Boonen, Hugo P.J., Moussa, Iftin Osman, García-Doval, Ignacio, Csányi, Ildíko, Brajac, Ines, Turchin, Irina, Grozdev, Ivan, Weinberg, Jeffrey M., Nicolopoulos, Jenny, Wells, Jillian, Lambert, Jo L.W., Ingram, John R. ORCID: https://orcid.org/0000-0002-5257-1142, Prinz, Jörg Christoph, de Souza Sittart, José Alexandre, Sanchez, Jose Luis, Hsiao, Josephine Pa-Fan, Castro-Ayarza, Juan Raul, Maul, Julia-Tatjana, van den Reek, Juul M.P.A., Trčko, Katarina, Barber, Kirk, Reich, Kristian, Gebauer, Kurt Aaron, Khobzei, Kuzma, Maul, Lara V., Massari, Larisa Prpić, Fardet, Laurence, le Cleach, Laurence, Misery, Laurent, Chandrashekar, Laxmisha, Muresanu, Lidia Irinel, Lecluse, Lidian, Skov, Lone, Frez, Ma. Lorna, Babić, Lucija Tomić, Puig, Lluís, Gomez, Luis Castro, Ramam, M., Dutil, Maha, El-Sayed, Mahira Hamdy, Olszewska, Malgorzata, Schram, Mandy Elvira, Franco, Manuel Dario, Llamas-Velasco, Mar, Gonçalo, Margarida, Velásquez-Lopera, Margarita M., Abad, Maria Eugenia, de Oliveira, Maria de Fátima Santos Paim, Seyger, Marieke M. B., Kaštelan, Marija, Rademaker, Marius, Sikora, Mariusz, Lebwohl, Mark, Wiseman, Marni C., Ferran, Marta, van Doorn, Martijn, Danespazhooh, Maryam, Bylaitė-Bucinskiene, Matilda, Gooderham, Melinda J., Polić, Melita Vukšić, de Rie, Menno A., Zheng, Min, Gómez-Flores, Minerva, Salleras i Redonnet, Montse, Silverberg, Nanette B., Doss, Nejib, Yawalkar, Nikhil, Chosidow, Olivier, Zargari, Omid, de la Cueva, Pablo, Fernandez-Peñas, Pablo, Cárdenas Rojas, Paola J., Gisondi, Paolo, Grewal, Parbeer, Sator, Paul, Luna, Paula Carolina, Félix, Paulo Antonio Oldani, Varela, Paulo, Holló, Péter, Cetkovska, Petra, Calzavara-Pinton, Piergiacomo, Ghislain, Pierre-Dominique, Araujo, Raquel Ruiz, Romiti, Ricardo, Kui, Róbert, Čeović, Romana, Vender, Ronald, Lafuente-Urrez, Rosario Fátima, del-Río, Rubén, Gulin, Sandra J., Handa, Sanjeev, Mahil, Satveer K., Kolalapudi, Seetharam A., Marrón, Servando E., Azimi, Seyyede Zeinab, Janmohamed, Sherief R., da Cruz Costa, Sidney Augusto, Choon, Siew Eng, Urbancek, Slavomir, Ayanlowo, Olusola, Margasin, Susana M., Wong, Tak-Wah, Mälkönen, Tarja, Hurtová, Tatiana, Reciné, Tatiana Riveros, Huldt-Nystrøm, Theis, Torres, Tiago, Liu, Tong-Yun, Leonidze, Tsira, Sharma, Vinod Kumar, Weightman, Warren, Gulliver, Wayne and Veldkamp, Wendelien 2022. International eDelphi study to reach consensus on the methotrexate dosing regimen in patients with psoriasis. JAMA Dermatology 158 (5) , pp. 561-572. 10.1001/jamadermatol.2022.0434

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Abstract

Importance A clear dosing regimen for methotrexate in psoriasis is lacking and this might lead to a suboptimal treatment. Since methotrexate is affordable and globally available, a uniform dosing regimen could optimize the treatment of psoriasis patients around the world. Objective Our objective was to reach international consensus among psoriasis experts on a uniform dosing regimen for methotrexate in adult and pediatric psoriasis patients. We also aimed to identify potential future research topics. Design Between September 2020 and March 2021, a survey study with a modified eDelphi procedure ran over three rounds. The proposals on which no consensus was reached, were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 nor agree/nor disagree, 7-9 agree). Setting This survey study was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants from all over the world of whom 34.5% resided in non-Western countries. Participants Participants were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (58.6%) and were experienced in treating psoriasis patients with methotrexate (88.7% had >10 years of experience). Main outcome(s) and Measure(s) In a survey with eDelphi procedure we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. Results From all participants, 71.7% (180/251) completed all three survey rounds and 58 participants joined the conference meeting. We achieved consensus on 11 proposals in round 1, on 3 proposals in round 2 and on 2 proposals in round 3. In the consensus meeting, we achieved consensus on 4 items. Especially for the proposals on folic acid and the dosing methotrexate in subpopulations -like children and vulnerable patients- more research is needed. Conclusion and relevance We reached consensus on 20 out of 21 proposals involving methotrexate dosing in psoriasis patients. This consensus may be used to harmonize the treatment with MTX in psoriasis patients.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine
Publisher:	American Medical Association
ISSN:	2168-6068
Date of First Compliant Deposit:	7 May 2022
Date of Acceptance:	30 March 2022
Last Modified:	17 Nov 2023 13:10
URI:	https://orca.cardiff.ac.uk/id/eprint/149606

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