title: Effects of low dose methotrexate on relapsing-remitting multiple sclerosis in comparison to Interferon β-1α: A randomized controlled trial.
abstract: BACKGROUND
  Methotrexate, a toxic antimetabolite that limits cellular reproduction by acting as an antagonist to folic acid, has been used to control autoimmune disease with different results. The aim of this study was to evaluate the effectiveness of low dose Methotrexate in the relapsing-remitting multiple sclerosis (RRMS).
  
  
  METHODS
  Eighty patients with definite RRMS aged 15 to 55 years were randomly allocated to receive a 12-month treatment course of either oral Methotrexate (7.5 mg/week) or intramuscular Interferon β-1α (30 μg/week). Response to treatment was assessed at 12 months after start of therapy.
  
  
  RESULTS
  The results of the study demonstrated significant reduction in relapse rate in both groups (p < 0.01). In 40 patients treated by Methotrexate, the mean value (SD) of relapse rate decreased from 1.75 (0.74) to 0.97 (0.83) (p < 0.01). Correspondingly, the mean value (SD) of relapse rate in patients treated by Interferon β-1α decreased from 1.52 (0.59) to 0.57 (0.78) (p < 0.01). Decrease of relapse rate in Interferon β-1α group was more than that in the other group (p = 0.06).
  
  
  CONCLUSIONS
  This study suggests that although treatment with Methotrexate may significantly reduce relapse rate and slow progression of disease in patients with RRMS, its efficacy is less than Interferon β-1α and it may be better used as add-on therapy.
authors.affiliation: Associate Professor, Department of Neurology, School of Medicine and Isfahan Neuroscience Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Fereshteh
authors.initials: F
authors.lastname: Ashtari
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Savoj
references.citation: CNS Drugs. 2005;19(3):239-52
references.pmid: 15740178
references.citation: Can J Neurol Sci. 2010 Jan;37(1):98-104
references.pmid: 20169781
references.citation: Tidsskr Nor Laegeforen. 2010 Mar 11;130(5):490-2
references.pmid: 20224616
references.citation: Neuron. 1999 Nov;24(3):511-4
references.pmid: 10595504
references.citation: J Immunol. 1995 Oct 15;155(8):4052-9
references.pmid: 7561116
references.citation: Clin Immunol. 2005 Feb;114(2):154-63
references.pmid: 15639649
references.citation: Proc Natl Acad Sci U S A. 2004 Oct 5;101 Suppl 2:14627-30
references.pmid: 15466699
references.citation: West J Med. 2000 Dec;173(6):398-402
references.pmid: 11112758
references.citation: J Neurol Neurosurg Psychiatry. 2008 Jan;79(1):52-6
references.pmid: 17846110
references.citation: Annu Rev Immunol. 1994;12:809-37
references.pmid: 8011298
references.citation: Drugs. 2008;68(17):2445-68
references.pmid: 19016573
references.citation: Lancet Neurol. 2010 Mar;9(3):231-3
references.pmid: 20117056
references.citation: Expert Opin Investig Drugs. 2009 Jul;18(7):985-9
references.pmid: 19527103
references.citation: Neurology. 2002 Jan 22;58(2):314-7
references.pmid: 11805267
references.citation: Ann Neurol. 1983 Mar;13(3):227-31
references.pmid: 6847134
references.citation: Neurol Sci. 2006 Mar;27 Suppl 1:S13-7
references.pmid: 16708175
references.citation: J Immunol. 2002 Mar 1;168(5):2501-7
references.pmid: 11859144
references.citation: Health Technol Assess. 2002;6(10):1-73
references.pmid: 12022938
references.citation: Presse Med. 2008 Nov;37(11):1644-51
references.pmid: 18819772
references.citation: Neurology. 1996 Nov;47(5):1153-7
references.pmid: 8909421
references.citation: Arthritis Rheum. 2008 Aug 15;59(8):1074-81
references.pmid: 18668604
references.citation: Mult Scler. 2002 Apr;8(2):139-41
references.pmid: 11990871
references.citation: Neurol Sci. 2001 Apr;22(2):209-10
references.pmid: 11603629
references.citation: Drugs Aging. 2008;25(10):879-84
references.pmid: 18808212
references.citation: Neurology. 1983 Nov;33(11):1444-52
references.pmid: 6685237
references.citation: BMJ Clin Evid. 2007 Aug 15;2007:
references.pmid: 19454107
references.citation: CNS Drugs. 2005;19(5):369-76
references.pmid: 15907149
references.citation: J Neurol Neurosurg Psychiatry. 1993 Nov;56(11):1217-8
references.pmid: 8229034
references.citation: CNS Drugs. 2004;18(6):379-96
references.pmid: 15089110
references.citation: J Neurol Neurosurg Psychiatry. 2001 May;70(5):574-9
references.pmid: 11309449
references.citation: Mult Scler. 2006 Aug;12(4):507-10
references.pmid: 16900766
references.citation: Neuropsychiatr Dis Treat. 2009;5:333-40
references.pmid: 19557143
references.citation: Curr Opin Neurol. 2000 Jun;13(3):263-70
references.pmid: 10871249
references.citation: Neurology. 1995 Jun;45(6 Suppl 6):S11-5
references.pmid: 7540264
references.citation: South Med J. 1997 Apr;90(4):367-75
references.pmid: 9114824
references.citation: Ann Neurol. 1995 Jan;37(1):30-40
references.pmid: 7818255
references.citation: J Neuroimmunol. 2005 Apr;161(1-2):101-12
references.pmid: 15748949
references.citation: J Neurol Sci. 2004 Aug 15;223(1):29-34
references.pmid: 15261557
references.citation: Neurology. 2004 Dec 28;63(12 Suppl 6):S41-6
references.pmid: 15623670