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Brief Paper

 

Usefulness of methotrexate in relapsing idiopathic retroperitoneal fibrosis

1, 2, 3, 4, 5, 6

 

  1. Haematology and Clinical Immunology Unit, Department of Medicine (DIMED), University of Padova, Italy. fabrizio.vianello@unipd.it
  2. Haematology Unit, Ospedale dell’Angelo, Mestre-Venezia, Italy.
  3. Internal Medicine and Allergology and Clinical Immunology Units, Treviso Ca' Foncello Hospital, Treviso, Italy.
  4. Internal Medicine and Allergology and Clinical Immunology Units, Treviso Ca' Foncello Hospital, Treviso, Italy.
  5. Haematology and Clinical Immunology Unit, Department of Medicine (DIMED), University of Padova, Italy.
  6. Cardiology Unit, Cardioimmunology Branch, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy.

CER16410
2023 Vol.41, N°7
PI 1544, PF 1547
Brief Paper

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PMID: 36912332 [PubMed]

Received: 29/11/2022
Accepted : 11/01/2023
In Press: 09/03/2023
Published: 10/07/2023

Abstract

OBJECTIVES:
Glucocorticoids are the mainstay for treatment of retroperitoneal fibrosis (RPF), a disease characterised by a periaortic proliferation of fibroinflammatory tissue frequently causing urinary obstruction. The therapeutic approach to patients unsuitable for steroid therapy and to relapsing cases is still undefined.
METHODS:
In this retrospective single-centre study we evaluated 15 patients with RPF who received second-line therapy with methotrexate (MTX) between January 2011 to December 2019.
RESULTS:
Fourteen out of 15 patients (93%) showed response to MTX. Two patients experienced relapse: one patient when on MTX therapy (28 months), the other, 58 months after MTX was interrupted. Liver toxicity grade 2 was documented in 2 patients and resolved with temporary dosage reduction. One patient stopped MTX autonomously because of nausea. No severe infections were recorded.
CONCLUSIONS:
In selected patients with RPF who are intolerant or refractory to steroid single therapy, MTX may be considered as useful and safe second-line treatment.

DOI: https://doi.org/10.55563/clinexprheumatol/atxzl5

Rheumatology Article