methylprednisolone + prednisone + methotrexate

This combination therapy regimen, consisting of methylprednisolone, prednisone, and methotrexate, was evaluated in the Phase III PRINTO JDM trial sponsored by the Istituto Giannina Gaslini for the treatment of newly diagnosed juvenile dermatomyositis (JDM). The protocol involves initial high-dose intravenous pulses of methylprednisolone to rapidly control systemic inflammation, followed by a tapering course of oral prednisone and weekly methotrexate as a steroid-sparing immunosuppressant. Methotrexate functions as a folate antimetabolite by inhibiting dihydrofolate reductase and thymidylate synthase, thereby disrupting DNA synthesis and the proliferation of inflammatory immune cells. The corticosteroids (prednisone and methylprednisolone) act as agonists at the glucocorticoid receptor, modulating gene expression to suppress the production of pro-inflammatory cytokines. The trial aimed to identify a treatment regimen that minimizes disease flares and drug-related toxicity in pediatric patients compared to corticosteroid monotherapy.

Other names

PRINTO JDM Trial methotrexate regimen