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Dermatomyositis has traditionally been treated with high doses of systemic corticosteroids. In recent years, methotrexate has been used as a steroid-sparing agent. These authors describe the efficacy and adverse effects of methotrexate in 10 adults treated over an 18-year period.
Seven patients had classic dermatomyositis and 3 had dermatomyositis sine myositis. Nine patients were treated weekly with low doses of oral methotrexate and one with intravenous methotrexate. All patients were also taking oral corticosteroids. Skin disease improved in 9 patients and myositis improved in 4. The one patient who did not respond had amyopathic dermatomyositis. Methotrexate was steroid-sparing -- the initial prednisone dose (average, 60 mg/day) was halv…