title: Prospective study of methotrexate treatment for rheumatoid arthritis treated legitimately according to the government recommended 8 mg/week dose.
abstract: Clinical squeal of the treatment of rheumatoid arthritis patients with methotrexate (MTX) according to the Japanese government recommended dose of 8 mg/week was evaluated prospectively. A total of 176 patients with active RA attending Konan Kakogawa Hospital and Kobe University Hospital were enrolled. Patients' profile at the start of study was Class 2.0 +/- 1.1 and X-ray stage 2.6 +/- 1.0. The effects of MTX treatment were evaluated by the American College of Rheumatology (ACR) core set, disease activity score of 28 joints (DAS28), and European League Against Rheumatism (EULAR) response criteria. A modified Sharp method was used to evaluate the radiographs. The improvement in the clinical signs and symptoms of the ACR core set was maintained for a 24-month period (p < 0.05). The ACR20/50/70 and DAS28 were also improved at the 12- and 24-month assessments. However, 82 of 130 patients (63.5%) were found to be nonresponders at 24 months of MTX therapy, as evaluated by EULAR response criteria. The X-ray study showed that joint destruction progressed despite the treatment. Thus, long-term MTX treatment performed in accordance with the Japanese 8 mg/week regimen appears to be favorable in terms of the signs and symptoms of RA; however, it is clearly insufficient for and cannot halt the progression of rheumatic joint destruction.
authors.affiliation: The Center for Rheumatic Diseases, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Hashiramoto
authors.forename: Kazuko
authors.initials: K
authors.lastname: Shiozawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamane
authors.forename: Miki
authors.initials: M
authors.lastname: Murata
authors.forename: Chihiro
authors.initials: C
authors.lastname: Tanaka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Terashima
authors.forename: Kozo
authors.initials: K
authors.lastname: Koyama
authors.forename: Natsuko
authors.initials: N
authors.lastname: Nakagawa
authors.forename: Shuji
authors.initials: S
authors.lastname: Abe
authors.forename: Rhosuke
authors.initials: R
authors.lastname: Yoshihara
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Saegusa
authors.forename: Ken
authors.initials: K
authors.lastname: Tsumiyama
authors.forename: Koichiro
authors.initials: K
authors.lastname: Komai
authors.forename: Yoshitada
authors.initials: Y
authors.lastname: Sakai
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D008727:Methotrexate