title: Methotrexate in rheumatoid arthritis: effects on disease activity in a multicenter prospective study.
abstract: One hundred and twenty-three patients with rheumatoid arthritis (RA) who successfully completed a randomized trial comparing oral methotrexate (MTX) to auranofin enrolled in a longterm prospective study of oral MTX. Of the 91 patients who completed 24 months of therapy, a significant (p = 0.0001) improvement was noted compared to baseline in all clinical disease variables and the Westergren erythrocyte sedimentation rate (ESR). Marked improvement occurred in 94 (76%) and 98 (80%) of the patients in the joint pain/tenderness index and joint swelling index at the last evaluable visit (mean 26 months). Of the 77 patients with an elevated ESR at baseline, 29 (38%) patients normalized it (less than 20 mm/h) while receiving therapy (p less than 0.01). A significant reduction in prednisone dose was also seen. Adverse events occurred frequently but were generally mild in severity. Twenty-seven patients (22%) withdrew during the study. Four (3%) withdrew due to lack of efficacy, and 6 (5%) because of adverse experiences. The overall probability of continuing therapy in the study for 48 months was projected at 72%. This large prospective study supports the observation of earlier smaller studies that MTX is an effective drug in the treatment of RA.
authors.affiliation: Department of Rheumatology and Immunology, Brigham and Women's Hospital, Boston, MA 02115.
authors.forename: M E
authors.initials: ME
authors.lastname: Weinblatt
authors.forename: H
authors.initials: H
authors.lastname: Kaplan
authors.forename: B F
authors.initials: BF
authors.lastname: Germain
authors.forename: R C
authors.initials: RC
authors.lastname: Merriman
authors.forename: S D
authors.initials: SD
authors.lastname: Solomon
authors.forename: B
authors.initials: B
authors.lastname: Wall
authors.forename: L
authors.initials: L
authors.lastname: Anderson
authors.forename: S
authors.initials: S
authors.lastname: Block
authors.forename: R
authors.initials: R
authors.lastname: Small
authors.forename: F
authors.initials: F
authors.lastname: Wolfe
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000473:pathology; D001799:Blood Sedimentation; D005260:Female; D006801:Humans; D007596:Joints / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D008727:Methotrexate