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Low dose methotrexate in rheumatoid arthritis
The Journal of Rheumatology
|November 1, 1982
Summary
Methotrexate (MTX) shows promise for severe rheumatoid arthritis (RA) unresponsive to standard treatments. While many patients improved, further research is needed due to side effects like liver issues.
Area of Science:
- Rheumatology
- Clinical Pharmacology
Background:
- Severe rheumatoid arthritis (RA) often presents resistance to conventional therapies.
- Methotrexate (MTX) is a potential therapeutic agent for autoimmune diseases.
Purpose of the Study:
- To systematically analyze the efficacy and safety of methotrexate (MTX) in patients with severe rheumatoid arthritis (RA).
Main Methods:
- An open-label, uncontrolled study involving 21 patients with severe RA.
- Patients received oral or intramuscular MTX (7.5-25 mg) for a mean duration of 38 weeks.
- Efficacy was assessed by clinical improvement and changes in sedimentation rate.
Main Results:
- Definite clinical improvement and reduced sedimentation rate observed in 52.4% of patients.
- Partial improvement noted in an additional 23.8% of patients.
- Two patients were unresponsive; three discontinued MTX due to adverse events (hepatitis, noncompliance, toxicity fears).
- Frequent reversible abnormal liver function tests were observed; other side effects were minor.
Conclusions:
- Methotrexate (MTX) may be an effective treatment option for severe rheumatoid arthritis (RA) refractory to conventional therapy.
- The study highlights the need for double-blind trials and long-term follow-up to establish MTX's role in RA management.
- Careful monitoring for liver function and potential toxicity is recommended.