methotrexate in rheumatoid arthritis
Last reviewed 01/2018
Response to treatment cannot be expected before 2 months and may not occur until after 6 months treatment.
- increasingly popular drug for this condition in the USA
- once weekly dose
- long term tolerability is better than that of gold, sulphasalazine, or penicillamine.
- disease suppression starts earlier that with other slow-acting antirheumatics and patients are less likely to stop treatment
- toxic effects include:
- pneumonitis in 3% of patients
- bone marrow suppression in approximately 3%
- opportunistic infections
- accelerated nodulosis of the hands
- cirrhosis and liver failure - very rarely
- overall side-effects are less common and can be minimised by folic acid supplementation
Reference:
- Porter DR. Medical management of rheumatoid arthritis. BMJ 1993; 307:425-428.
- Drug and Therapeutics Bulletin (1995). Methotrexate and rheumatoid arthritis. 33(3):17-19.
- Current Problems in Pharmacovigilance 2000; 26: 10.
pre-treatment screening for methotrexate
clinical adverse events on methotrexate