(3.30)
Based on 66 studies
| Side Effect | Affected |
|---|---|
| Elevated liver tests | 15% |
| Nausea/vomiting | 10% |
| Stomatitis | 3% |
| Thrombocytopenia | 3% |
Image for illustration purposes only. Actual medication may appear different.
Image for illustration purposes only. Actual medication may appear different.
Highlights
- 40-50% improvement in eczema severity
- Results visible within 3-7 weeks
- Long-term treatment possible (average 23 months)
- Maintains effectiveness after stopping treatment
- Requires regular monitoring
- Shouldn't be used during pregnancy
- ⚠️ This medication carries a boxed warning. This is the Food and Drug Administration's (FDA's) most stringent warning for prescription drugs, indicating a serious or life-threatening risk associated with the medication.
Methotrexate is slower to work but can be effective for long-term control of atopic dermatitis. It typically takes at least 6 weeks to see effects. The medication works by decreasing inflammation through inhibiting cell division and lymphocyte proliferation.
| Study Summary | Study Type | Studied Population | Results |
|---|---|---|---|
|
📄
Newer treatments for atopic dermatitis (like dupilumab, tralokinumab, lebrikizumab, and JAK inhibitors) are showing better results with fewer side effects compared to older medications. High dose cyclosporine and dupilumab work better than methotrexate and azathioprine. While high-dose upadacitinib was most effective, it had more side effects.
|
Review |
Severity: moderate to severe Age: not available
|
High dose cyclosporine and dupilumab showed superior efficacy compared to methotrexate and azathioprine. High-dose upadacitinib showed highest efficacy but with more adverse events. |
|
📄
This study compared two medications for moderate-to-severe eczema: methotrexate and cyclosporine. While cyclosporine worked better at 8 weeks, increasing the dose of methotrexate led to similar effectiveness by 20 weeks. Cyclosporine had more side effects than methotrexate.
|
Clinical Trial |
Total Patients: 97
|
Cyclosporine was more effective than methotrexate at 8 weeks |
Newer treatments for atopic dermatitis (like dupilumab, tralokinumab, lebrikizumab, and JAK inhibitors) are showing better results with fewer side effects compared to older medications. High dose cyclosporine and dupilumab work better than methotrexate and azathioprine. While high-dose upadacitinib was most effective, it had more side effects.
Comparison of Old and New Systemic Treatments for Moderate to Severe Atopic DermatitisThis study compared two medications for moderate-to-severe eczema: methotrexate and cyclosporine. While cyclosporine worked better at 8 weeks, increasing the dose of methotrexate led to similar effectiveness by 20 weeks. Cyclosporine had more side effects than methotrexate.
Methotrexate Versus Cyclosporine in Adults with Moderate-to-Severe Atopic Dermatitis: A Phase III Randomized Noninferiority Trial.Common side effects include nausea, vomiting, diarrhea, and fatigue. More serious but rare side effects include liver toxicity and low blood counts, which requires regular blood test monitoring. Taking folic acid supplements helps reduce these side effects.
| Study Summary | Study Type | Studied Population | Results |
|---|---|---|---|
|
📄
Newer treatments for atopic dermatitis (like dupilumab, tralokinumab, lebrikizumab, and JAK inhibitors) are showing better results with fewer side effects compared to older medications. High dose cyclosporine and dupilumab work better than methotrexate and azathioprine. While high-dose upadacitinib was most effective, it had more side effects.
|
Review |
Severity: moderate to severe Age: not available
|
High dose cyclosporine and dupilumab showed superior efficacy compared to methotrexate and azathioprine. High-dose upadacitinib showed highest efficacy but with more adverse events. |
Newer treatments for atopic dermatitis (like dupilumab, tralokinumab, lebrikizumab, and JAK inhibitors) are showing better results with fewer side effects compared to older medications. High dose cyclosporine and dupilumab work better than methotrexate and azathioprine. While high-dose upadacitinib was most effective, it had more side effects.
Comparison of Old and New Systemic Treatments for Moderate to Severe Atopic DermatitisWhen compared to other treatments, methotrexate shows lower effectiveness than cyclosporine and dupilumab in the short term (8 weeks), but may have better long-term outcomes. In children, methotrexate shows better drug survival rates than cyclosporine but lower than dupilumab.
| Study Summary | Study Type | Studied Population | Results |
|---|---|---|---|
|
📄
This study compared two medications for moderate-to-severe eczema: methotrexate and cyclosporine. While cyclosporine worked better at 8 weeks, increasing the dose of methotrexate led to similar effectiveness by 20 weeks. Cyclosporine had more side effects than methotrexate.
|
Clinical Trial |
Total Patients: 97
|
Cyclosporine was more effective than methotrexate at 8 weeks |
|
📄
This study compared how long children with severe eczema stayed on different medications (dupilumab, methotrexate, and cyclosporine). Dupilumab showed the best long-term results, with 84% of patients still using it after 1 year, compared to 61% for methotrexate and 44% for cyclosporine. The main reasons patients stopped treatments were because they weren't working well enough or because of side effects.
|
Comparative Study |
Total Patients: 362
Severity: moderate to severe Age: 2-17 years
|
Dupilumab showed consistently better long-term continuation rates compared to methotrexate and cyclosporine |
This study compared two medications for moderate-to-severe eczema: methotrexate and cyclosporine. While cyclosporine worked better at 8 weeks, increasing the dose of methotrexate led to similar effectiveness by 20 weeks. Cyclosporine had more side effects than methotrexate.
Methotrexate Versus Cyclosporine in Adults with Moderate-to-Severe Atopic Dermatitis: A Phase III Randomized Noninferiority Trial.This study compared how long children with severe eczema stayed on different medications (dupilumab, methotrexate, and cyclosporine). Dupilumab showed the best long-term results, with 84% of patients still using it after 1 year, compared to 61% for methotrexate and 44% for cyclosporine. The main reasons patients stopped treatments were because they weren't working well enough or because of side effects.
Drug Survival of Dupilumab, Methotrexate, and Cyclosporine A in Children With Atopic Dermatitis.The medication can be used as a maintenance therapy for longer-term control of atopic dermatitis, unlike cyclosporine which is typically limited to one year of use due to side effects.
| Study Summary | Study Type | Studied Population | Results |
|---|---|---|---|
|
📄
Newer treatments for atopic dermatitis (like dupilumab, tralokinumab, lebrikizumab, and JAK inhibitors) are showing better results with fewer side effects compared to older medications. High dose cyclosporine and dupilumab work better than methotrexate and azathioprine. While high-dose upadacitinib was most effective, it had more side effects.
|
Review |
Severity: moderate to severe Age: not available
|
High dose cyclosporine and dupilumab showed superior efficacy compared to methotrexate and azathioprine. High-dose upadacitinib showed highest efficacy but with more adverse events. |
|
📄
Both cyclosporine and methotrexate were effective in treating severe eczema in children and young people. Cyclosporine worked faster, but methotrexate's effects lasted longer after stopping treatment.
|
Randomized Controlled Trial |
Total Patients: 103
Severity: severe Age: 2-16 years
|
Newer treatments for atopic dermatitis (like dupilumab, tralokinumab, lebrikizumab, and JAK inhibitors) are showing better results with fewer side effects compared to older medications. High dose cyclosporine and dupilumab work better than methotrexate and azathioprine. While high-dose upadacitinib was most effective, it had more side effects.
Comparison of Old and New Systemic Treatments for Moderate to Severe Atopic DermatitisBoth cyclosporine and methotrexate were effective in treating severe eczema in children and young people. Cyclosporine worked faster, but methotrexate's effects lasted longer after stopping treatment.
Efficacy and safety of ciclosporin versus methotrexate in the treatment of severe atopic dermatitis in children and young people (TREAT): a multicentre, parallel group, assessor-blinded clinical trial.Is Methotrexate Right For Me?
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Your journey with lemma health
Discover effective treatments with board‑certified dermatologists.
Get prescriptions for immediate relief.
Get your medications.
Design a plan for sustained relief with your personal care coordinator.
Experience less itch, reduced inflammation, better sleep, and improved wellbeing.
Review progress with your care team and fine-tune your plan.
Ensure that you have everything you need to maintain your relief.
Don't worry - your coordinator will remain available to you.
Enjoy 24/7/365 access to your dedicated care team.
Discover effective treatments with board‑certified dermatologists.
Get prescriptions for immediate relief.
Get your medications.
Design a plan for sustained relief with your personal care coordinator.
Experience less itch, reduced inflammation, better sleep, and improved wellbeing.
Enjoy 24/7/365 access to your dedicated care team.
Ensure that you have everything you need to maintain your relief.
Don't worry - your coordinator will remain available to you.
Review progress with your care team and fine-tune your plan.
Illustrative journey. Individual timelines and results may vary.
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At Lemma Health, we provide evidence-based skin care. Access dermatologists in all 50 states - appointments available within 3 days. Receive your medications delivered. Message your dedicated care team 24/7/365.
What are others saying?
The following comments are sourced from publicly available forums, including Reddit. They reflect personal opinions and anecdotal experiences, and do not constitute medical advice. Lemma Health does not verify the accuracy, completeness, or authorship of these statements, nor does it endorse any specific treatment, medication, or outcome mentioned. These excerpts are provided for informational purposes only.
Currently my skin is the softest it has been in years. I am rarely itchy and any dry patches I get are more easily controlled. It has greatly increased my quality of life.
View SourceShe explained that I could go for light therapy, but after a treatment of 12 weeks it could come back quite easily. Then she adviced to start with methotrexate (an immunosuppressive). I gladly took it. The MTX takes about 8-12 weeks for it to work, but my symptoms are so bad at the moment that she gave me prednison to cope with it in the meantime.
View Source2 months in, I started to feel the difference. The itching was minimal and my skin was a lot softer. Even if i scratched my eczema patches, the skin did not break so easily. The effects take some time but you will start to realise the changes slowly.
View SourceWe collect reviews of treatments from various sources including social media and are not always able to verify whether these have been written by actual patients.