methotrexate in the treatment of steroid dependent asthma

despite the role of oral corticosteroids in management of sever asthma, use of these drugs needs careful awareness of its many side effects. there are controversies about the role of methotrexate in lowering the need for corticosteroides in these patients. in this study an attempt has been made to determine methotrexate effects in corticosteroid dependent asthma. six patients were entered in a double-blind placebo controlled crossover trial and randomly allocated to two groups. each group got a 12 weeks course of treatment with 15 milligrams of methotrexate or placebo which thereafter was changed to the other regimen. in comparison with placebo, methotrexate caused a 62.5% less need for oral corticosteroid (p<0.01) and a 20% increase in fev1 (p<0.05). we concluded that the use of low doses of oral methotrexate results in less need for oral corticosteroid in treatment of corticosteroid dependent asthma.