Related Experiment Video

Updated: Aug 5, 2026

Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
09:44

Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss

Published on: January 25, 2016

Methotrexate in the management of immune mediated cochleovesitibular disorders: clinical experience with 53 patients

L H Salley1, M Grimm, A Sismanis

  • 1Department of Otolaryngology, Head and Neck Surgery, Medical College of Virginia at Virginia Commonwealth University, Richmond 23298, USA.

The Journal of Rheumatology
|May 22, 2001
PubMed
Abstract

Insights

Low dose weekly methotrexate (MTX) effectively managed immune-mediated cochleovestibular disorder (IMCVD), improving vertigo, hearing loss, and tinnitus in most patients with minimal toxicity.

Area of Science:

  • Otolaryngology
  • Rheumatology
  • Pharmacology

Background:

  • Immune-mediated cochleovestibular disorder (IMCVD) presents challenges in management, often requiring long-term treatment.
  • Corticosteroids are frequently used but can lead to relapses and side effects.
  • Alternative therapeutic strategies are needed for sustained symptom control.

Purpose of the Study:

  • To evaluate the efficacy and safety of low-dose weekly methotrexate (MTX) for IMCVD.
  • To assess MTX's impact on vestibular symptoms, hearing loss, and tinnitus in IMCVD patients.

Main Methods:

  • Retrospective analysis of 53 IMCVD patients treated with weekly MTX (7.5-25 mg).
  • Patients had progressive vestibular symptoms, often with corticosteroid dependence or relapse.
  • Outcomes assessed via audiologic studies and symptom reporting (vertigo, tinnitus).

Main Results:

  • Overall symptom improvement observed in 70% (35/50) of patients.
  • Significant improvements reported in vertigo (69%), hearing loss (53%), and tinnitus (26%).
  • Low toxicity reported, with 4 patients discontinuing MTX due to adverse events.

Conclusions:

  • Low-dose weekly methotrexate is an effective and well-tolerated treatment option for IMCVD.
  • MTX offers a viable alternative for long-term management of IMCVD, reducing reliance on corticosteroids.
  • Sustained symptom control was achieved in a significant proportion of patients.

More Related Videos

A Comparative Study of Drug Delivery Methods Targeted to the Mouse Inner Ear: Bullostomy Versus Transtympanic Injection09:18

A Comparative Study of Drug Delivery Methods Targeted to the Mouse Inner Ear: Bullostomy Versus Transtympanic Injection

Published on: March 8, 2017

A Surgical Procedure for the Administration of Drugs to the Inner Ear in a Non-Human Primate Common Marmoset (Callithrix jacchus)06:55

A Surgical Procedure for the Administration of Drugs to the Inner Ear in a Non-Human Primate Common Marmoset (Callithrix jacchus)

Published on: February 27, 2018

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...