Prednisone vs Methotrexate: Which has fewer side effects?

Patients with pulmonary sarcoidosis are often treated with prednisone as a first-line pharmacological treatment and methotrexate as second-line therapy.

A small study evaluated patient-reported side-effects of prednisone and methotrexate in a real-world sarcoidosis population.

Of the 56 patients who completed a questionnaire on medication use, 89% had used prednisone and 70% had used methotrexate. Patients reported significantly more side-effects with prednisone (78%) compared with methotrexate (49%).

The authors noted that these findings needed to be confirmed in a prospective study.

Reference
Kahlmann V, Moor CC, Veltkamp M, et al. Patient reported side-effects of prednisone and methotrexate in a real-world sarcoidosis population. Chron Respir Dis. 2021 Jan-Dec;18:14799731211031935. doi: 10.1177/14799731211031935. PMID: 34569301.