Summary
Low-dose methotrexate has gained widespread acceptance as a second-line agent in rheumatoid arthritis (RA). The Leeds Human Model Screening System (LHMSS) is a validated screening mechanism allowing the rapid evaluation of compounds for their potential as anti-rheumatic agents, the results of which have been confirmed in longer term studies. We have evaluated methotrexate in patients with RA using the LHMSS at a maintenance dose of 10mg/week. Significant change occurred in four out of eleven variables over a 24-week period (p<0.01). This degree of change is greater than that seen with nonsteroidal anti-inflammatory agents but less than with other recognised second-line agents such as D-penicillamine, suggesting that methotrexate may have less potential as a second-line agent than D-penicillamine.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gubner, R., August, S., Ginsberg, V. Therapeutic suppression of tissue reactivity. II. Effect of aminopterin in rheumatoid arthritis and psoriasis. Am J Med Sci 1951, 221, 165–182.
Kremer, J.M., Phelps, C.T. Long-term prospective study of the use of methotrexate in the treatment of rheumatoid arthritis. Update after a mean of 90 months. Arthritis Rheum 1992, 35 (2), 138–145.
Williams, H.J., Willkens, R.F., Samuelson, C.O., et al. Comparison of low-dose oral pulse methotrexate in the treatment of rheumatoid arthritis: a controlled clinical trial. Arthritis Rheum 1985, 28, 721–730.
Weinstein, A., Marlowe, S., Korn, J., Farouhar, F. Low dose methotrexate treatment of rheumatoid arthritis: long-term observations. Am J Med 1985, 79, 331–337.
Wolfe, F., Hawley, D.J., Cathey, M.A. Termination of slow acting anti-rheumatic therapy in rheumatoid arthritis: A 14-year prospective evaluation of 1017 consecutive starts. J Rheumatol 1990, 17, 994–1002.
Hawley, D.J., Wolfe, F. Are the results of controlled clinical trials and observational studies of second-line therapy in rheumatoid arthritis valid and generalisable as measures of rheumatoid outcome: Analysis of 122 studies. J Rheumatol 1991, 18, 1008–1014.
Furst, D.E., Kremer, J.M. Methotrexate in rheumatoid arthritis. Arthritis Rheum 1988, 31, 305–314.
Stenger, A.A.M.E., Houtman, P.M., Bruyn, G.A.W. Does folate supplementation make sense in patients with rheumatoid arthritis treated with methotrexate? Ann Rheum Dis 1992, 51, 1019–1020.
Dixon, J.S., Bird, H.A., Pickup, M.E., Wright, V. A Human Model Screening System for the detection of specific anti-rheumatic activity. Semin Arth Rheum 1982, 12, 185–190.
Ropes, N.W., Bennett, G.A., Cobb, S., Jacox, R., Jessar, R.A. 1958 revision of diagnostic criteria for rheumatoid arthritis. Bull Rheum Dis 1958, 9, 175–176.
Bird, H.A., Dixon, J.S., Finney, P.L., et al. A clinical and biochemical evaluation of clozic, a novel disease modifying drug in rheumatoid arthritis. Clin Exp Rheumatol 1983, 1, 93–99.
Dixon, J.S. Biochemical and clinical changes in rheumatoid arthritis; their relation to the action of anti-rheumatic drugs. PhD Thesis 1981 University of Leeds.
Thompson, R.N., Watts, C., Edelman, J., Russell, A.S. A controlled two centre trial of parenteral methotrexate therapy for refractory rheumatoid arthritis. J Rheumatol 1984, 11, 760–763.
Stewart, K.A., Mackenzie, A.H., Clough, J.D., Wilke, W.S. Folate supplementation in methotrexate-treated rheumatoid arthritis patients. Semin Arthritis Rheum 1991, 20, 332–338.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tait, T.J., Le Gallez, P., Astbury, C. et al. A clinical and biochemical assessment of methotrexate in rheumatoid arthritis. Clin Rheumatol 13, 75–79 (1994). https://doi.org/10.1007/BF02229869
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02229869