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Sometimes topical therapies do not control atopic dermatitis (AD), and physicians prescribe antimetabolites or immunosuppressive agents. To determine whether azathioprine works better than methotrexate, investigators conducted a single-blind, randomized, 12-week trial comparing efficacy, safety, and change in quality of life with the two systemic treatments. All 43 study patients (age >18; mean age, 40) had severe AD (mean Scoring Atopic Dermatitis [SCORAD] score, 58; mean Skindex-17 quality-of-life score, 51). Twenty patients received methotrexate (mean dose, 20 mg once weekly), and 23 received azathioprine (mean dose, 2.2 mg/kg/day); concomitant topical treatment was permitted.
No statistical differences between methotrexate and azathiopri…