title: Prospective long term follow-up of methotrexate therapy in rheumatoid arthritis: toxicity, efficacy and radiological progression.
abstract: We followed all 128 patients started on methotrexate (MTX) for rheumatoid arthritis (RA) over a 4-year period. Forty-nine were followed for over 3 years. Forty-three patients discontinued treatment, 23 because of toxicity, 15 for inefficacy and five for other reasons. Forty-seven of the 75 followed on treatment for over 2 years had hand radiographs available before and after this treatment period. None showed improvement and 15 showed marked deterioration. Patients' acceptance of this therapy was good although most were noted objectively to have persistent disease activity. We would recommend that if MTX is to be used, a more aggressive approach be adopted to reduce not only the symptoms but the signs of active disease.
authors.affiliation: Rheumatic Disease Unit, University of Alberta, Edmonton, Canada.
authors.forename: P S
authors.initials: PS
authors.lastname: Hanrahan
authors.forename: G A
authors.initials: GA
authors.lastname: Scrivens
authors.forename: A S
authors.initials: AS
authors.lastname: Russell
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D001772:Blood Cell Count / Q000187:drug effects; D005500:Follow-Up Studies; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D008727:Methotrexate