20 May 2025 • In a multicenter trial of treatment-naive patients with pulmonary sarcoidosis, methotrexate was noninferior to prednisone as first-line therapy.

Key Findings:

• At 24 weeks, mean forced vital capacity improved by 6.75 percentage points with prednisone and 6.11 with methotrexate; the between-group difference (−1.17 points) was within the noninferiority margin of 5 points.
• While adverse event rates were similar, side effects differed.
• Prednisone was linked to weight gain and insomnia, whereas methotrexate caused more nausea and liver enzyme elevations.

These findings position methotrexate as an effective, steroid-sparing alternative to guide shared treatment decisions.

Source: The New England Journal of Medicine | Read Full Story