Design a clinical information system.

group of patients.'9 KFC: What is the role of methotrexate as a steroid sparing agent? DMG: Our recent study showed that low dose methotrexate had a substantial steroid sparing effect in a moderately large group of patients, but not in all patients.4 It should be reserved for patients with severe side effects from steroids; the side effects of long term methotrexate treatment are not fully documented. KFC: In summary, hormonal factors seem to be important in this case. Asthma symptoms worsened after menarche and there was a close relation between symptoms and menstruation. Suppression of menstruation with progesterone improved her condition, although it resulted in depression and unacceptable weight gain. Prolonged treatment with oral corticosteroid had serious systemic side effects. Methotrexate was introduced as a steroid sparing drug to reduce the risk of further musculoskeletal complications and greatly facilitated control of her asthma; the success of this approach in our patient suggests that a trial of methotrexate may be warranted in young asthmatic patients who are steroid dependent. Monthly bisphosphonate infusions resulted in an appreciable increase in lumbar bone mineral density.