Dermatologists' adherence to the guideline of the Dutch Society of Dermatology and Venereology with respect to the treatment with methotrexate for severe chronic plaque psoriasis: results from a Dutch survey.
SourceDermatology, 215, 1, (2007), pp. 45-52
Article / Letter to editor
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SubjectCTR 2: Clinical Pharmacology and physiology; N4i 1: Pathogenesis and modulation of inflammation; N4i 4: Auto-immunity, transplantation and immunotherapy; UMCN 4.2: Chronic inflammation and autoimmunity
BACKGROUND: In 2003, the Dutch guideline 'Photo(chemo) therapy and systemic therapy for severe chronic plaque psoriasis' was established. OBJECTIVES: To document how closely this guideline is followed in clinical practice with respect to the methotrexate (MTX) treatment and to formulate recommendations to adjust the guideline. METHODS: A survey was conducted among Dutch dermatologists and residents in dermatology. The questionnaire assessed the knowledge of and the adherence to the guideline with respect to MTX treatment. RESULTS: Fifty percent of the contacted dermatologists/residents responded. Fifty-two percent follow the guideline with respect to MTX. Liver biopsy and the frequency of blood investigations cause a discrepancy between guideline and reality. There is a lack of consensus between guidelines of the different specialisms concerning liver biopsy. CONCLUSION: The need for liver biopsies in combination with the frequent check-ups and the lack of consensus between rheumatologists, hepatologists and dermatologists seem to restrict the adherence to the guideline.
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