Low-dose methotrexate: an effective corticosteroid-sparing agent in the musculoskeletal manifestations of sarcoidosis

Br J Rheumatol. 1995 Jul;34(7):642-4. doi: 10.1093/rheumatology/34.7.642.


Extrapulmonary sarcoidosis, and particularly the presence of musculoskeletal complications of the disease, may require chronic corticosteroid therapy. In five patients with biopsy-proven sarcoidosis and presenting recalcitrant forms of the disease, we introduced low-dose oral methotrexate (MTX) [10 mg/week (7.5-15)] for 30 months (16-34) to control the clinical and biological symptoms as well as to try to reduce the intolerated steroid posology. Beneficial effects were observed within 8-12 weeks in all patients, which allowed a reduction of 59% (35-75) of the corticosteroid posology, and maintained with a follow-up of 3 yr in 4/5 patients. No significant toxicity was observed. MTX appears to be an efficient, safe and corticosteroid-sparing therapeutic agent for the treatment of recalcitrant musculoskeletal manifestations of sarcoidosis.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Humans
  • Male
  • Methotrexate / administration & dosage*
  • Methotrexate / therapeutic use
  • Middle Aged
  • Musculoskeletal Diseases / diagnostic imaging
  • Musculoskeletal Diseases / drug therapy*
  • Musculoskeletal Diseases / etiology*
  • Radiography
  • Sarcoidosis / complications*
  • Treatment Outcome


  • Adrenal Cortex Hormones
  • Methotrexate