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Related Experiment Videos

Methotrexate for rheumatoid arthritis.

M E Suarez-Almazor1, E Belseck, B Shea

  • 1Health Services Research, Veterans Affairs Medical Center, Mailbox Station 152, 2002 Holcombe Blvd, Houston, Texas 77024, USA. mes@bcm.tmc.edu

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary
This summary is machine-generated.

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Methotrexate (MTX) significantly benefits rheumatoid arthritis (RA) treatment short-term, improving various measures. However, MTX use led to higher withdrawal rates due to adverse effects compared to placebo.

Area of Science:

  • Rheumatology
  • Clinical Pharmacology
  • Evidence-Based Medicine

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease requiring effective treatment.
  • Methotrexate (MTX) is a commonly used disease-modifying antirheumatic drug (DMARD).
  • Short-term efficacy and toxicity data for MTX in RA require synthesis.

Purpose of the Study:

  • To estimate the short-term efficacy of methotrexate (MTX) for rheumatoid arthritis (RA).
  • To assess the toxicity associated with MTX treatment in RA patients.
  • To provide a meta-analysis of randomized controlled trials comparing MTX to placebo.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) and controlled clinical trials.
  • Searched Cochrane Musculoskeletal Group trials register and Medline up to July 1997.

Related Experiment Videos

  • Pooled analysis using standardized mean differences (SMDs) for efficacy and odds ratios (OR) for toxicity.

    • Main Results:

    • Five trials with 300 patients were included, showing statistically significant benefits for MTX over placebo.
    • MTX demonstrated significant improvements in joint counts, pain, and functional assessments (SMD -0.43 to -1.5).
    • While overall withdrawal rates were similar, MTX patients were more likely to discontinue due to adverse reactions (OR=3.47).

    Conclusions:

    • Methotrexate (MTX) offers substantial clinical and statistical benefits in the short-term treatment of rheumatoid arthritis (RA).
    • Twenty-two percent of MTX patients withdrew due to adverse effects, versus seven percent in the placebo group.
    • MTX is effective but requires careful monitoring for toxicity in RA management.