British Association of Dermatologists’ guidelines for the safe and effective prescribing of methotrexate for skin disease 2016

Abstract

This set of guidelines has been developed using the British Association of Dermatologists' recommended methodology, PubMed, MEDLINE and Embase databases and the Cochrane Library were searched for meta-analyses, randomized and nonrandomized controlled clinical trials, case series, case reports and open studies involving MTX to October 2015; search terms and strategies are detailed in the Supporting Information. Additional relevant references were also isolated from citations in reviewed literature, as well as specific targeted searches for drug interactions, combination therapy, pretreatment tests and latent tuberculosis reactivation. All identified English-language titles were screened and those relevant for first-round inclusion were selected for further scrutiny. The abstracts for the shortlisted references were then reviewed by all members of the working group and the full papers of relevant material obtained; disagreements in the final selections were resolved by discussion with the entire development group. Case reports and case series were only considered if there was no higher-quality evidence available. The structure of the guidelines was then discussed, with headings and subheadings decided; different co-authors were allocated separate subsections. Each co-author then performed a detailed appraisal of the selected literature with discussions within the GDG to resolve any issues, and all subsections were subsequently collated, circulated within the GDG and edited to produce the final guidelines.