Toxicity of methotrexate in rheumatoid arthritis.
Seventy-two patients with rheumatoid arthritis had been treated with pulse weekly oral methotrexate with a mean followup of one year. Minor side effects (oral ulcers, transient elevation of liver enzymes, nausea, vomiting) were present in 46 patients (63.8%), whereas major side effects (severe infection, cytopenia, respiratory failure, seizures, gastrointestinal bleeding) were present in 7 (9.7%), 2 of whom died. Patients with major side effects had shorter disease duration and increased frequency of extraarticular manifestations as compared to those with no side effects. No association between a particular clinical or genetic variable and occurrence of side effects to methotrexate was found.
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008584:Meningitis, Listeria / Q000209:etiology; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000139:chemically induced; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced
D006680:HLA Antigens; D008727:Methotrexate