[Methotrexate (MTX) in the treatment of rheumatoid arthritis]

The efficacy of MTX in the treatment of 35 cases of rheumatoid arthritis (RA) was evaluated. MTX was administered orally (8 cases) or intramuscularly (27 cases) in doses of 15-20 mg per week over a 3 months period. At the completion of three months courses, all clinical parameters measured except for 15 meters walking time, including joint pain count, joint tenderness/swelling counts and scores, morning stiffness, grip strength, joint functional state and rheumatoid nodule were significantly improved (P less than 0.01 or P less than 0.05). The erythrocyte sedimentation rate and rheumatoid factor were also improved significantly after therapy. Four patients were in complete remission, 20 patients had important improvement, 10 patients had clinical improvement, and one unchanged. The drug adverse effect was mild and transient. Gastrointestinal upset was most frequently seen (45.7%), mild leukopenia occurred in 4 patients, skin rash in 2, herpes simplex in 1. No patient were withdrawn drug owing to the untoward effect. We consider that MTX is a useful and safe mode of treatment for RA.