title: High dose intravenous methotrexate with leucovorin rescue in rheumatoid arthritis.
abstract: Five patients with severe, treatment refractory rheumatoid arthritis were treated with high dose intravenous methotrexate (500 mg/m2) followed by leucovorin (50 mg/m2). Four courses of chemotherapy were given over a 2-month interval. At the end of the final course, there was a 50% or greater improvement in joint swelling and pain indices and morning stiffness in all patients. Clinical responses persisted for 6-14 weeks posttherapy. High dose methotrexate-leucovorin was associated with a significant reduction in DR antigen expression on peripheral Leu 2, Leu 3 and Leu 4 lymphocytes.
authors.affiliation: Arthritis and Rheumatism Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD.
authors.forename: J
authors.initials: J
authors.lastname: Shiroky
authors.forename: C
authors.initials: C
authors.lastname: Allegra
authors.forename: G
authors.initials: G
authors.lastname: Inghirami
authors.forename: B
authors.initials: B
authors.lastname: Chabner
authors.forename: C
authors.initials: C
authors.lastname: Yarboro
authors.forename: J H
authors.initials: JH
authors.lastname: Klippel
mesh_terms: D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007275:Injections, Intravenous; D002955:Leucovorin / Q000627:therapeutic use*; D008727:Methotrexate / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D010146:Pain; D010865:Pilot Projects; D012008:Recurrence; D013601:T-Lymphocytes / Q000145:classification / Q000276:immunology
chemical_list: D006684:HLA-DR Antigens; D002955:Leucovorin; D008727:Methotrexate