title: Methotrexate: clinical and immunological effects in refractory rheumatoid arthritis.
abstract: Thirty five patients with refractory rheumatoid arthritis were given 7.5 mg of methotrexate (Mtx) every week. Eleven patients had to discontinue treatment either because of adverse effects or unresponsiveness. Twenty four patients showed clinical response and significant improvement in ESR and they continued Mtx for a mean of 25.24 months. Seven patients achieved clinical remission as defined by ARA criteria. Immunological parameeters including IgG, IgM, IgA, lymphocyte subsets (CD3+, CD4+, CD8+ and B), C3 and C4 however, did not show any change during this treatment in any of the groups upto 6 months. There was a significant fall in the erythrocyte sedimentation rate (ESR), c-reactive protein (CRP) and rheumatoid factor (RF) levels in responders only.
authors.affiliation: Dept. of Medicine, All India Institute of Medical Sciences, New-Delhi.
authors.forename: Y
authors.initials: Y
authors.lastname: Singh
authors.forename: M
authors.initials: M
authors.lastname: Sharma
authors.forename: R R
authors.initials: RR
authors.lastname: Singh
authors.forename: A
authors.initials: A
authors.lastname: Kumar
authors.forename: R
authors.initials: R
authors.lastname: Malaviya
authors.forename: A N
authors.initials: AN
authors.lastname: Malaviya
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D001799:Blood Sedimentation / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D011446:Prospective Studies; D012074:Remission Induction; D014839:Vomiting / Q000139:chemically induced
chemical_list: D008727:Methotrexate