Gerbens LAA, et al. - Researchers probed the long-term efficacy, safety and drug survival of methotrexate (MTX) and azathioprine (AZA) in moderate-to-severe atopic dermatitis (AD). Mean absolute and relative reduction in SCORing Atopic Dermatitis (SCORAD) index and Investigator's Global Assessment (IGA) after 5 years compared with baseline were the primary effectiveness outcomes. Up to 5 years, MTX and AZA seemed to be effective and safe as maintenance treatments in moderate-to-severe AD. In both groups, few patients survived on their originally allocated drug although some discontinued because of controlled AD. A longer survival for MTX was demonstrated by the drug survival, but survival in both groups was low after 5 years.