Use of MTX in the elderly and in patients with compromised renal function.
The absorption and distribution of MTX are unchanged in the elderly compared to younger RA patients, while both metabolism and renal/biliary excretion of MTX may be affected by age and should be considered when using this drug. Neither haemodialysis nor peritoneal dialysis effectively clears MTX, although high-flux dialysis may prove to be effective. The efficacy of MTX is equivalent in the young and elderly. The adverse event profile reveals a higher frequency of GI, lower and haematological toxicity in older patents, although the overall profile is not qualitatively different.
Division of Rheumatology, Department of Medicine, David Geﬀen School of Medicine at University of California, Los Angeles, CA 90025-1670, USA.
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D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000503:physiopathology*; D008727:Methotrexate / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D012216:Rheumatic Diseases / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D008727:Methotrexate