title: Methotrexate in severe ankylosing spondylitis: an open study.
abstract: OBJECTIVE
  To study the efficacy and toxicity of methotrexate (MTX) for patients with ankylosing spondylitis (AS) in a 36 week, open, single observer study.
  
  
  METHODS
  Patients were selected for study if they had evidence of active disease and had failed to respond to treatment with nonsteroidal antiinflammatory drugs (NSAID) and sulfasalazine. Eleven patients entered the study, and 9 were evaluated at the end. Oral MTX (7.5-15 mg weekly) was given for at least 24 weeks; NSAID were kept at a stable dose. Efficacy was evaluated by calculating the relative difference of assessed variable between Week 0 and 24 and by patient evaluation.
  
  
  RESULTS
  Assessed variables showed good relative improvement. Four patients decided to continue MTX; 3 used a lower dose of NSAID; one stopped NSAID: Five patient patients discontinued MTX: 3 of these had disease flares and restarted MTX. Side effects were mild and reversible.
  
  
  CONCLUSIONS
  Results of our study showed that the majority of our patients with AS taking MTX had beneficial effects.
authors.affiliation: Department of Rheumatology, St. Radbound Academic Hospital Nijmegen, The Netherlands.
authors.forename: M C
authors.initials: MC
authors.lastname: Creemers
authors.forename: M J
authors.initials: MJ
authors.lastname: Franssen
authors.forename: L B
authors.initials: LB
authors.lastname: van de Putte
authors.forename: F W
authors.initials: FW
authors.lastname: Gribnau
authors.forename: P L
authors.initials: PL
authors.lastname: van Riel
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000503:physiopathology; D012460:Sulfasalazine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D012460:Sulfasalazine; D008727:Methotrexate