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Long-term experience with low dose methotrexate in rheumatoid arthritis
1Department of Rheumatology, Tel Aviv Medical Center, Tel Aviv University Sackler School of Medicine, Israel.
Rheumatology International
|January 1, 1993
Summary
Methotrexate (MTX) therapy is effective for rheumatoid arthritis (RA) patients, with high continuation rates and significant improvement observed. Seronegative patients showed better adherence to MTX treatment.
Area of Science:
- Rheumatology
- Clinical Pharmacology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease requiring long-term management.
- Methotrexate (MTX) is a cornerstone therapy for RA, but long-term efficacy and tolerability data are crucial.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of low-dose methotrexate (MTX) in rheumatoid arthritis (RA) patients.
- To assess factors influencing MTX therapy continuation and patient outcomes.
Main Methods:
- A cohort of 126 RA patients received weekly low-dose MTX for a mean of 36.8 months.
- Long-term continuation rates, improvement levels, and adverse events were analyzed.
- Comparison of outcomes between seronegative and seropositive patients was performed.
Main Results:
- MTX continuation probability remained high (65%) at 5-7 years.
- 45% of patients experienced marked improvement, with 6% achieving complete remission.
- Seronegative patients had a significantly higher probability of continuing MTX therapy (P < 0.05).
- A significant decrease in prednisone and NSAID use was noted.
- Minor side effects were common (68%), but major complications leading to discontinuation were infrequent (21%) and mostly occurred within 24 months.
- Malignancy rates did not exceed expected levels.
Conclusions:
- Low-dose methotrexate is a well-tolerated and effective long-term treatment for rheumatoid arthritis.
- Seronegativity is associated with better MTX therapy adherence.
- MTX therapy allows for reduced use of concomitant medications like prednisone and NSAIDs.