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Low-dose weekly oral methotrexate therapy for inflammatory arthritis
Clinical Pharmacy
|June 1, 1986
Summary
Low-dose, weekly oral methotrexate (MTX) effectively treats inflammatory arthritis, improving joint swelling, stiffness, pain, and activity. While some side effects occurred, MTX showed no significant liver toxicity in this study.
Area of Science:
- Rheumatology
- Pharmacology
Background:
- Inflammatory arthritis necessitates effective treatments.
- Conventional therapies like gold, penicillamine, and hydroxychloroquine have limitations.
- Methotrexate (MTX) is a potential therapeutic option for refractory cases.
Purpose of the Study:
- To evaluate the efficacy and toxicity of low-dose, weekly oral methotrexate (MTX) for inflammatory arthritis.
- To assess MTX's impact on disease activity and joint damage.
- To monitor for adverse effects, including liver and pulmonary toxicity.
Main Methods:
- Fifty-nine patients with inflammatory arthritis received weekly oral or IV MTX (10-20 mg).
- Patients were assessed over 24 months using various arthritis-specific tests.
- Radiographic hand studies and liver biopsies were performed for select patients.
Main Results:
- Significant improvements were observed in joint swelling, morning stiffness, pain, and activity levels.
- 23 out of 35 patients showed no new joint erosions after one year of MTX therapy.
- 31 patients experienced mild side effects (GI, mucocutaneous, elevated liver enzymes); 3 had pulmonary toxicity.
Conclusions:
- Weekly oral methotrexate is an effective treatment for inflammatory arthritis unresponsive to other therapies.
- Short-term MTX therapy demonstrated no clinically significant liver disease.
- MTX offers a viable treatment option with manageable toxicity profiles for inflammatory arthritis.