Effect of Methotrexate on Inflammatory Response in Adult Atopic Dermatitis Patients

NCT ID: NCT03327116

Last Updated: 2019-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-01

Study Completion Date

2018-12-01

Brief Summary

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Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with pruritus. Methotrexate can be used to treat refractory disease to conventional therapy.

It will be conducted a single arm trial with twelve adult patients with moderate to severe AD on methotrexate for 24 weeks.

Investigators intend to evaluate the effect methotrexate on cytokines and chemokines involved in the inflammatory response, on IgE levels, on pruritus, and on EASI and SCORAD severity scores.

Detailed Description

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Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with pruritus. Methotrexate (MTX) can be used to treat refractory disease to conventional therapy, but there are few studies showing its effect on the profile of cytokines involved in the inflammatory response.

Objectives: To assess the effect of MTX on the cytokines involved in the inflammatory response of adult AD patients treated with methotrexate for 24 weeks. As specific objectives, investigators intend to assess the evolution of serum IgE levels, the EASI (Eczema Area and Severity Index) and SCORAD (Scoring Atopic Dermatitis) severity scores and pruritus in them.

Methods: It will be conducted an open, prospective study with twelve adult patients with moderate to severe AD on MTX for 24 weeks. Each participant is expected to attend 7 visits during 6 months of follow-up. In clinical healthy and injured skin, two assessments will be performed: 1) mRNA expression of IL-4, IL-10, IL-17A, IL-22, IL-31, oncostatin M receptor (OSMR), alpha subunit IL-31 (IL-31RA) receptor, TNF-α, IFN-γ, TSLP, TARC and MDC by Real Time-PCR at the initial week and week 24; 2) expression of IL-31, IL-31RA, OSMR, TSLP and Ki67 by immunohistochemistry at the initial week and week 24.

Skin samples from non-atopic subjects will be utilized as controls for the assays, paired by gender and age.

Additional analysis of serum levels of IgE (nephelometric method) at the initial week and week 24 of the study will be performed.

AD severity scores (EASI and SCORAD) will be tested and pruritus will be analyzed by a visual analog scale at the initial, week 12 and week 24.

Conditions

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Atopic Dermatitis

Keywords

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atopic dermatitis pruritus methotrexate inflamation IL-31

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Methotrexate

Group Type EXPERIMENTAL

Methotrexate

Intervention Type DRUG

oral, 15 mg per week, 24 weeks

Interventions

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Methotrexate

oral, 15 mg per week, 24 weeks

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* AD (Hanifin and Rajka criteria) moderate to severe (EASI ≥ 7.1 and SCORAD ≥ 25);
* Age ≥ 18 years;
* Women without the potential to become pregnant or using an effective method of contraception and with a negative pregnancy blood test;
* Men without a desire of pregnancy and who use condom in sexual intercourse.

Exclusion Criteria

* Hepatic and / or renal insufficiency;
* Anemia, thrombocytopenia and / or leukopenia;
* Use of concomitant hepatotoxic drug;
* Active infection;
* Allergy to MTX;
* Excessive alcohol intake;
* Difficulty to understand how to take methotrexate;
* HIV infection or other immunosuppression condition;
* Therapy with UVA or UVB, corticoid, cyclosporine, immunobiological, azathioprine within 12 weeks prior to introduction of methotrexate.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Sao Paulo General Hospital

OTHER

Sponsor Role lead

FUNADERSP (Foundation for Research Support of the State of São Paulo)

UNKNOWN

Sponsor Role collaborator

Responsible Party

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Valéria Aoki

Associate Professor and Director of International Relations

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Hospital das Clínicas of the University of São Paulo Medical School, Department of Dermatology

São Paulo, São Paulo, Brazil

Site Status

Countries

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Brazil

References

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Samorano LP, Manfrere KCG, Pereira NV, Takaoka R, Valente NYS, Sotto MN, Silva LFF, Sato MN, Aoki V. Methotrexate for refractory adult atopic dermatitis leads to alterations in cutaneous IL-31 and IL-31RA expression. An Bras Dermatol. 2024 Jan-Feb;99(1):72-79. doi: 10.1016/j.abd.2023.01.002. Epub 2023 Sep 18.

Reference Type DERIVED
PMID: 37730501 (View on PubMed)

Other Identifiers

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13.368

Identifier Type: -

Identifier Source: org_study_id