| The use of methotrexate in rheumatoid arthritis. | |
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MedLine Citation:
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PMID: 15305245 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To address the long-term efficacy and toxicity issues related to methotrexate (MTX) and compare it with other disease-modifying antirheumatic drugs (DMARDs). METHODS: Review of the international literature on the clinical use of MTX in rheumatoid arthritis (RA) disease. RESULTS: MTX has emerged as a relatively safe and effective treatment for RA that compares favorably with other therapies, particularly because of its considerably longer median drug survival. The toxicity profile of MTX is well established and includes serious and sometimes fatal liver disease, pneumonitis, and cytopenias. Hence, regular and careful monitoring of patients taking MTX is essential, particularly when MTX is combined with other DMARDs. Folate supplementation can reduce some of the most common side effects of MTX, but it has not yet been established whether this translates into a reduced risk of serious disease. Another potential approach to reducing the toxicity of MTX is therapeutic drug monitoring and dose individualization. However, correlations between pharmacokinetics and clinical response have been addressed in only a few studies and with conflicting results. CONCLUSIONS: MTX is an effective DMARD with a relatively safe profile compared with other therapies. Folate supplementation can significantly reduce the risk of MTX toxicity. Finally, it is essential that patients be monitored carefully to reduce the potential serious toxicities of MTX. |
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Authors:
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Andrea T Borchers; Carl L Keen; Gurtej S Cheema; M Eric Gershwin |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Seminars in arthritis and rheumatism Volume: 34 ISSN: 0049-0172 ISO Abbreviation: Semin. Arthritis Rheum. Publication Date: 2004 Aug |
Date Detail:
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Created Date: 2004-08-12 Completed Date: 2004-12-09 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1306053 Medline TA: Semin Arthritis Rheum Country: United States |
Other Details:
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Languages: eng Pagination: 465-83 Citation Subset: IM |
Affiliation:
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Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, 95616, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Antirheumatic Agents / administration & dosage* Arthritis, Rheumatoid / diagnosis*, drug therapy* Dose-Response Relationship, Drug Drug Administration Schedule Female Follow-Up Studies Humans Male Maximum Tolerated Dose Methotrexate / administration & dosage*, adverse effects Middle Aged Pain Measurement Randomized Controlled Trials as Topic Risk Assessment Severity of Illness Index Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antirheumatic Agents; 59-05-2/Methotrexate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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