Study finds, Efficacy of Methotrexate in Linear Scleroderma
Researchers aimed to study the disease course and long-term outcome in children with linear scleroderma (SSc) treated with methotrexate (MTX) since diagnosis.

The present study was retrospective and cross-sectional and included consecutive children with linear SSc who were treated with MTX for more than 1 year and were followed up for at least 2 years. Disease course was analyzed by the number of relapses and treatment changes. Relapse-free survival was examined by Kaplan-Meier analysis, comparing patients with linear SSc and those with other juvenile localized scleroderma (JLS) disease subtypes.

--50 patients with a mean follow-up duration of 7.8 years and a mean MTX treatment duration of 3.1 years were included.

--16% of patients did not respond to the first course of MTX, and 16% had at least 1 flare.

--Complete remission was observed in 18.2% of patients who were followed up for 2–5 years, in 80.0% of patients followed up for 10 years, and in 87.5% of patients followed up for more than 10 years.

--No significant difference in relapse-free survival between patients with linear SSc and in 17 patients with other JLS disease subtypes was observed.

--Tissue damage was mild in 42% of patients, moderate in 32%, and severe in 26%. The correlations between severity of tissue damage and linear SSc subtype, disease duration, relapses, and remission were not significant.

--The relationships between treatment duration and disease relapses and severity of tissue damage were significant.

Patients with linear SSc who are treated with MTX, in particular, obtain complete and long-term remission. Overall, the cosmetic and functional consequences are moderate, most likely due to early tissue injury and treatment that likely stabilizes the damage. Early diagnosis and MTX treatment, as well as long-term surveillance, are critical for improving outcomes and detecting flares as soon as possible.