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Methotrexate in Rheumatoid Arthritis

  • Conference paper
Symposium in Immunology I and II

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Abstract

Methotrexate is an established therapy for rheumatoid arthritis. It is also being utilized in a variety of other rheumatological conditions, autoimmune diseases, and inflammatory disorders. Several open studies over the past 20 years have reported efficacy and an acceptable tolerability profile with low-dose methotrexate in rheumatoid arthritis. These open studies report a moderate to marked improvement in selected clinical parameters [1–5]. The results from these uncontrolled trials have generated sufficient interest to initiate randomized placebo-controlled studies. Four randomized placebo controlled trials have been performed (Table 1), and all report efficacy with methotrexate [6–9]. In a 24-week double-blind cross-over study of low-dose weekly methotrexate versus placebo in 35 patients, an improvement in clinical parameters began as early as 3 weeks after initiation of methotrexate [7]. An improvement in the standard rheumatoid arthritis parameters was seen in this study in which the dose of methotrexate ranged from 7.5 to 15.0 mg per week. In this cross-over study an increase in disease activity occurred within 3 weeks after methotrexate discontinuation. A similar clinical response was observed in an 18-week randomized multicenter trial in which 189 patients were randomized to receive oral methotrexate (7.5–15.0 mg/week) or placebo [6].

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  1. M. E. Weinblatt
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Editors and Affiliations

  1. Institut für Immunologie der Universität Wien, Borschkegasse 8 a, 1090, Wien, Austria

    Martha M. Eibl

  2. Abteilung für Hämatologie, Johannes Gutenberg Universität, Langenbeckstr. 1, 6500, Mainz, Germany

    Christoph Huber

  3. Abteilung für Rheumatologie und Klinische Immunologie, Medizinische Universitätsklinik, Hugstetter Str. 55, 7800, Freiburg i.Br., Germany

    Hans H. Peter

  4. Päd. Pneumologie und Immunologie, Univ.-Klinikum Rudolf Virchow, Standort Charlottenburg, Heubnerweg 6, 1000, Berlin 19, Germany

    Ulrich Wahn

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Weinblatt, M.E. (1993). Methotrexate in Rheumatoid Arthritis. In: Eibl, M.M., Huber, C., Peter, H.H., Wahn, U. (eds) Symposium in Immunology I and II. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78087-5_21

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  • DOI: https://doi.org/10.1007/978-3-642-78087-5_21

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