Higher Doses of Methotrexate in the Treatment of Rheumatoid Arthritis

Journal/Book: Z Rheumatol 1998; 57 Suppl. 1: 82 (P 149). 1998;

Abstract: Rheumatology Univ. Med. School Lublin Methotrexate (MTX) is nowadays one of the most commonly used drug in the treatment of rheumatoid arthritis (RA). However some patients do not respond to the treatment with the most commonly used low doses of MTX (up to 10 mg/week). Clinical experience and publication in literature suggest that the therapeutic effect of MTX is dose-dependent. The objective of the study was to evaluate the efficacy and tolerability of therapy with higher doses of MTX (15 - 20 mg/week) in RA patients not responding to lower doses of the drug. The study group consisted of 69 patients (48 women and 21 men) at the age of 22 - 72 suffering from active RA refractory to the 3-month or longer treatment with lower MTX doses. The clinical and laboratory parameters were assessed (number of tender joints number of swollen joints ESR hemoglobin platelet count). Criteria of slight improvement: 1. decrease in the number of tender joints at least 30 % 2. decrease in the number of swollen joints at least 30 % 3. decrease of ESR at least 15 %. Criteria of significant improvement: 1. decrease in the number of tender joints at least 50 % 2. decrease in the number of swollen joints at least 50 % 3. decrease of ESR at least 30 %. Improvement was observed in 46 cases (66 7 %): significant improvement was achieved in 31 patients (44 9 %) slight improvement in 15 patients (21 8 %). No improvement was noticed in 23 patients (33 3 %). Side effects were observed in 28 cases (40 6 %) (elevation of transaminases dyspeptic symptoms subcutaneous nodules leucopenia oral ulceration vertigo hair loss). ... le

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