{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T22:08:05Z","timestamp":1768774085237,"version":"3.49.0"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021201","name":"European Academy of Dermatology and Venereology","doi-asserted-by":"publisher","award":["PPRC\u20102021\u201016"],"award-info":[{"award-number":["PPRC\u20102021\u201016"]}],"id":[{"id":"10.13039\/501100021201","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite the widespread off\u2010label use of methotrexate (MTX) for the treatment of atopic dermatitis (AD), there is limited high\u2010quality evidence on dosing regimens and existing guidelines do not provide clear recommendations regarding dosing strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to achieve international consensus among AD experts to standardize the dosing regimen for MTX treatment in adults and children with AD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An electronic Delphi (eDelphi) study was conducted from October 2021 to September 2022. Recruitment was conducted through dermatology societies and AD interest groups. Participation was open to dermatologists and dermatology residents experienced in treating AD patients with MTX. The study consisted of three online rounds. The first round was informed by a systematic review of relevant literature, and subsequent rounds were adjusted based on the results of the previous round. Participants voted on 19 proposals using a 9\u2010point scale (1\u20133 disagree, 4\u20136 neither agree nor disagree, 7\u20139 agree). Consensus was achieved when at least 70% of participants agreed, and less than 15% disagreed. Proposals that did not reach consensus in the first three rounds were discussed in a consensus meeting, where consensus was defined as less than 30% disagreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 152 participants completed Round 1, 104 (68%) completed all survey rounds, and 43 (28%) joined the consensus meeting. Consensus was achieved on 7 proposals in Round 1, 4 in Round 2 and 6 in Round 3. The final 2 proposals reached consensus during the consensus meeting. Consensus topics include test dose, start dose, maximum dose, administration route, dosing schedule, management of stopping treatment, treatment duration and folic acid supplementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This eDelphi study achieved consensus on 19 proposals related to MTX dosing for adults and children with AD. These results aim to guide prescribing decisions and encourage a standardized global approach to MTX use in AD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.20271","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T12:39:50Z","timestamp":1722515990000},"page":"331-339","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["International consensus on methotrexate dosing for patients with atopic dermatitis: An <scp>eDelphi<\/scp> study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5793-2664","authenticated-orcid":false,"given":"Anouk G. 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Gemelli \u2010 IRCCSUOC di Dermatologia  Rome Italy"},{"name":"Dipartimento di Medicina Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro CuoreDermatologia  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather A.","family":"Brandling\u2010Bennett","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Pediatrics University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7388-9475","authenticated-orcid":false,"given":"Aaron M.","family":"Drucker","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine University of Toronto and Women's College Hospital, and the Women's College Research Institute, Women's College Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6035-2863","authenticated-orcid":false,"given":"Phyllis I.","family":"Spuls","sequence":"additional","affiliation":[{"name":"Dermatology Amsterdam UMC Location University of Amsterdam  Amsterdam The\u00a0Netherlands"},{"name":"Amsterdam Public Health, Infection and Immunity University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the MTX Consensus for AD Survey Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8]]},"reference":[{"issue":"6","key":"e_1_2_13_2_1","first-page":"5","article-title":"Brief update on dermatologic uses of methotrexate","volume":"24","author":"Shah RA","year":"2019","journal-title":"Skin Therapy Lett"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.12862"},{"key":"e_1_2_13_4_1","unstructured":"SmPC text Methotrexate.2019. 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