Open AccessMethotrexate in rheumatoid arthritis. a five‐year prospective multicenter study
Author(s) -
Weinblatt Michael E.,
Kaplan Herbert,
Germain Bernard F.,
Block Sidney,
Solomon Sheldon D.,
Merriman Richard C.,
Wolfe Frederick,
Wall Bruce,
Anderson Larry,
Gall Eric,
Torretti Dennis,
Weissman Barbara
Publication year - 1994
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.1780371013
Subject(s) - medicine , erythrocyte sedimentation rate , tolerability , rheumatoid arthritis , methotrexate , prospective cohort study , adverse effect , surgery , clinical trial , arthritis
Objective . To evaluate the efficacy and tolerability of oral methotrexate (MTX) in rheumatoid arthritis (RA) in a long‐term prospective trial. Methods . One hundred twenty‐three patients with RA who completed a 9‐month multicenter randomized trial comparing MTX and auranofin enrolled in this 5‐year prospective study of MTX. Results . Significant ( P = 0.0001) improvement compared with baseline was noted in all clinical disease variables, functional status, and the Westergren erythrocyte sedimentation rate (ESR). “Marked improvement” occurred in 87 (71%) and 85 (69%) of the patients, respectively, in the joint pain/tenderness index and the joint swelling index at the last evaluable visit. Forty‐four patients (36%) withdrew during the study. Eight (7%) withdrew due to lack of efficacy, and 8 (7%) due to adverse experiences, including 1 patient with cirrhosis. At 5 years, 64% of patients were still taking MTX and completed the study. Conclusion . This large prospective study of long‐term MTX treatment demonstrates sustained clinical response and improvement in the Westergren ESR and functional assessment scores, with an acceptable toxicity profile.