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Published on: October 6, 2023
Methotrexate treatment of rheumatoid arthritis: effects on radiological progression
S Reykdal1, K Steinsson, K Sigurjónsson
1Department of Rheumatology, National University Hospital, Reykjavík, Iceland.
Abstract:
Radiological progression was evaluated in 15 patients with rheumatoid arthritis (RA) treated with methotrexate (MTX). Prior to MTX treatment, all the patients had failed on other slow-acting agents and all showed radiological deterioration. For each patient, three sets of radiographs of hands and wrists were evaluated: prior to MTX treatment while on other slow-acting agents, at the beginning of MTX treatment, and at the most recent evaluation on MTX. Two experienced radiologists evaluated the radiographs independently. The rate of radiological progression was calculated by dividing the change in radiological score by the number of months between sets of radiographs. The mean time from film set one to two (period one) was 29.4 months and from set two to three (period two) 32.5 months. The mean rate of radiological progression for period one was 0.576 and for period two, 0.381. Eight patients showed decline in radiological progression during MTX treatment.
Insights
Methotrexate (MTX) treatment may slow radiological progression in rheumatoid arthritis (RA) patients who previously showed deterioration. Eight of fifteen patients experienced reduced joint damage progression while on MTX therapy.
Area of Science:
- Rheumatology
- Radiology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation and damage.
- Patients with RA often experience radiological deterioration despite treatment with conventional slow-acting agents.
- Methotrexate (MTX) is a common disease-modifying antirheumatic drug (DMARD) used in RA management.
Purpose of the Study:
- To evaluate the effect of methotrexate (MTX) on the rate of radiological progression in patients with rheumatoid arthritis (RA).
- To assess changes in radiological damage in RA patients before and during MTX treatment.
Main Methods:
- Retrospective analysis of hand and wrist radiographs from 15 RA patients.
- Radiographs were assessed at three time points: before MTX, at MTX initiation, and during MTX treatment.
- Radiological progression rate was calculated by comparing changes in radiological scores over time.
Main Results:
- The mean rate of radiological progression decreased from 0.576 (period one) to 0.381 (period two) during MTX treatment.
- Eight out of fifteen patients demonstrated a decline in their rate of radiological progression while on MTX.
- All patients initially showed radiological deterioration prior to MTX therapy.
Conclusions:
- Methotrexate (MTX) therapy appears to reduce the rate of radiological progression in rheumatoid arthritis (RA) patients.
- MTX may be beneficial in halting or slowing joint damage in RA patients refractory to other slow-acting agents.
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