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One such medication is methotrexate (MTX), which has been widely used in autoimmune and autoinflammatory diseases, but its role in treating pemphigus remains somewhat unclear and controversial. This study aimed to evaluate the effect and safety profile of using low\u2010dose MTX in PV patients receiving glucocorticoids. PV patients who visited the Department of Dermatology, Peking University First Hospital from January 2010 to December 2021 were retrospectively screened. Based on different treatment regimens, patients were automatically divided into a corticosteroid monotherapy group and a corticosteroid combined with low\u2010dose MTX group (MTX was administered at a dose of no more than15\u2009mg per week, with a minimum duration of 8\u2009weeks). All patients were followed up for 1\u2009year. A total of 142 patients with PV were eligible for the study (100 in the corticosteroid monotherapy group and 42 in the corticosteroid combined with low\u2010dose MTX group). The Kaplan\u2013Meier curve indicated that the corticosteroid combined with low\u2010dose MTX group achieved a 50% reduction in glucocorticoid use faster, with a <jats:italic>P<\/jats:italic> value of 0.0132, especially among patients who initially received more than 60\u2009mg of steroids per day. The inclusion of MTX reduced the occurrence of hyperpilidemia. There was not sufficient evidence to determine if the addition of MTX was associated with more bacterial infection cases for certain. The inclusion of low\u2010dose MTX in the corticosteroid treatment regimen for patients with PV, particularly those receiving high doses, can facilitate the reduction of glucocorticoid dosages and lower the incidence of hyperlipidemia, without increasing the risk of other adverse effects.<\/jats:p>","DOI":"10.1111\/1346-8138.17636","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T09:34:36Z","timestamp":1738661676000},"page":"695-700","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Corticosteroids combined with low\u2010dose methotrexate in the treatment of pemphigus vulgaris: A retrospective cohort study"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7582-4424","authenticated-orcid":false,"given":"Yan","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Dermatology Peking University First Hospital  Beijing 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University First Hospital  Beijing China"},{"name":"National Clinical Research Center for Skin and Immune Diseases  Beijing China"},{"name":"Beijing Key Laboratory of Molecular Diagnosis on Dermatoses  Beijing China"},{"name":"NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan","family":"Chong","sequence":"additional","affiliation":[{"name":"Peking University Health Science Center  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panpan","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Dermatology Peking University First Hospital  Beijing China"},{"name":"National Clinical Research Center for Skin and Immune Diseases  Beijing China"},{"name":"Beijing Key Laboratory of Molecular Diagnosis on Dermatoses  Beijing China"},{"name":"NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics  Beijing 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