{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T20:33:15Z","timestamp":1784752395429,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T00:00:00Z","timestamp":1468972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust J Dermatology"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Systemic oral immunomodulators azathioprine, methotrexate and cyclosporin are widely used in paediatric dermatology. Routine blood tests are performed to minimise drug\u2010related adverse events. However, the frequency of monitoring tests may lead to significant fearful experiences for patients. We reviewed haematological abnormalities and clinical side\u2010effects in a paediatric clinic population commencing immunomodulators for dermatological conditions, where haematological profiles are monitored less frequently than in current recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review of children started on azathioprine, methotrexate or cyclosporin for a dermatological condition between 2001\u20132015 from a primarily paediatric, private dermatology practice was performed. Blood tests were done at baseline, 1\u00a0month, 2\u00a0months and then 3\u2010monthly for children on azathioprine. Children on methotrexate and cyclosporin had tests done at baseline, after 1\u00a0month and then 3\u2010monthly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 242 children were included in this study. Azathioprine, methotrexate and cyclosporin cohorts had 95, 97 and 50 patients treated for a mean duration of 656, 758 and 313\u00a0days, respectively. Isolated abnormal blood tests indicated the cessation of azathioprine in 3\/95 (3%), methotrexate in 5\/97 (5%) and cyclosporin in 2\/50 (4%) of patients. Abnormal blood test results were not associated with any reported clinical side\u2010effects in the azathioprine (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.726), methotrexate (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.06) or cyclosporin groups (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.250).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our experience, less frequent monitoring did not result in any significant adverse events over a 15\u2010year period. We suggest that haematological monitoring during immunosuppressants use can be safely reduced from current recommendations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajd.12526","type":"journal-article","created":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T08:29:49Z","timestamp":1469003389000},"page":"31-40","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Monitoring recommendations for oral azathioprine, methotrexate and cyclosporin in a paediatric dermatology clinic and literature review"],"prefix":"10.1111","volume":"59","author":[{"given":"Joy","family":"Yee","sequence":"first","affiliation":[{"name":"Department of Dermatology Royal Children's Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Orchard","sequence":"additional","affiliation":[{"name":"Department of Dermatology Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Department of Medicine University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.08.038"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10575.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12505"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/02739618109450691"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.08.048"},{"key":"e_1_2_8_7_1","first-page":"2501","article-title":"Guidelines for blood test monitoring of methotrexate toxicity in juvenile idiopathic arthritis","volume":"31","author":"Ortiz\u2010Alvarez O","year":"2004","journal-title":"J. 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