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Serum levels and pharmacodynamics of methotrexate and its metabolite 7-hydroxy methotrexate in Japanese patients with rheumatoid arthritis treated with 2-mg capsule of methotrexate three times per week

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Modern Rheumatology

Abstract

Methotrexate (MTX) is the first-choice drug for rheumatoid arthritis (RA); however, the pharmacodynamics of MTX in Japanese patients with RA treated legitimately according to the government recommended dosage, 6 mg per week, are unknown. Methotrexate and its metabolite, 7-hydroxy MTX (7-OH MTX), were measured in sera of 16 outpatients with active RA in the first week of MTX treatment and 4–12 weeks after the introduction at 0, 1, 2, 4, and 8 h after administration of the first and the third 2-mg capsule, followed by sampling at 48, 96, and 168 h. The mean maximal serum drug concentration (mean Cmax) of MTX attained at 1–2 h after ingestion of the first capsule was 0.215 and 0.252 µM, respectively, in the first and the follow-up week. The mean Cmax after ingestion of the third capsule was 0.223 µM and 0.357 µM. The mean Cmax of 7-OH MTX was 0.0334 and 0.0289 µM for the first capsule, and 0.0495 and 0.0672 µM for the third capsule. The results indicate that MTX does not accumulate or deposit in the body of Japanese patients with RA when treated with 6 mg per week, and pharmacodynamics of MTX are comparable to those in overseas patients treated with 7.5 mg per week.

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References

  1. American College of Rheumatology Subcommittee on rheumatoid arthritis guidelines: Guidelines for the management of rheumatoid arthritis 2002 update. Arthritis Rheum 2002;46:328–46

    Google Scholar 

  2. Y Suzuki (2002) ArticleTitleMethotrexate for the treatment of rheumatoid arthritis in Japan – much more still remains to be resolved (in Japanese) Nippon Rinsho 60 2331–8 Occurrence Handle12510358

    PubMed  Google Scholar 

  3. HK Choi MA Hernan JD Seeger JM Robins F Wolfe (2002) ArticleTitleMethotrexate and mortality in patients with rheumatoid arthritis: A prospective study Lancet 359 1173–7 Occurrence Handle10.1016/S0140-6736(02)08213-2 Occurrence Handle11955534 Occurrence Handle1:CAS:528:DC%2BD38XivVShsrw%3D Occurrence Handle000174846300006

    Article  PubMed  CAS  ISI  Google Scholar 

  4. ME Weinblatt AL Maier PA Fraser JS Coblyn (1998) ArticleTitleLong-term prospective study of methotrexate in rheumatoid arthritis: Conclusion after 132 months of therapy J Rheumatol 25 238–42 Occurrence Handle9489813 Occurrence Handle1:CAS:528:DyaK1cXhtVGgu7w%3D

    PubMed  CAS  Google Scholar 

  5. GD Kozloski JM DE Vito JC Kisicki JB Johnson (1992) ArticleTitleThe effect of food on the absorption of methotrexate sodium tablets in healthy volunteers Arthritis Rheum 35 761–4 Occurrence Handle1622413 Occurrence Handle1:CAS:528:DyaK38Xlslyiu74%3D

    PubMed  CAS  Google Scholar 

  6. M Ahern J Booth A Loxton P McCarthy P Meffin S Kevat (1988) ArticleTitleMethotrexate kinetics in rheumatoid arthritis: Is there an interaction with nonsteroidal antiinflammatory drugs? J Rheumatol 15 1356–60 Occurrence Handle3199396 Occurrence Handle1:STN:280:BiaD28fmtVU%3D

    PubMed  CAS  Google Scholar 

  7. RA Herman P Veng-Pedersen J Hoffman R Koehnke DE Furst (1989) ArticleTitlePharmacokinetics of low-dose methotrexate in rheumatoid arthritis patients J Pharm Sci 78 165–71 Occurrence Handle2715941 Occurrence Handle1:STN:280:BiaB3sngslM%3D

    PubMed  CAS  Google Scholar 

  8. KM Halprin K Fukui A Okawara (1971) ArticleTitleBlood levels of methotrexate and the treatment of psoriasis Arch Dermatol 103 243–9 Occurrence Handle10.1001/archderm.103.3.243 Occurrence Handle5107871 Occurrence Handle1:STN:280:CS6C3sjltVE%3D

    Article  PubMed  CAS  Google Scholar 

  9. RA Hamilton JM Kremer (1995) ArticleTitleThe effect of food on methotrexate absorption J Rheumatol 22 630–2 Occurrence Handle7791153 Occurrence Handle1:STN:280:ByqA3M7isVw%3D

    PubMed  CAS  Google Scholar 

  10. S Kevat M Ahern P Hall (1988) ArticleTitlePancytopenia induced by low-dose methotrexate for rheumatoid arthritis Aust N Z Med J 18 697–700 Occurrence Handle1:STN:280:BiaB38josFM%3D

    CAS  Google Scholar 

  11. FC Arnett SM Edworthy DA Bloch DJ McShane JF Fries NS Cooper et al. (1988) ArticleTitleThe american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis Arthritis Rheum 31 315–24 Occurrence Handle3358796 Occurrence Handle1:STN:280:BieC1M3nt1Q%3D

    PubMed  CAS  Google Scholar 

  12. T Hirai M Kitamura Y Inoue (1994) ArticleTitleSensitive analytical procedure for methotrexate and its main metabolite 7-hydroxymethotrexate in serum by high-performance liquid chromatography (in Japanese) Yakugaku Zasshi 114 602–10 Occurrence Handle7932104 Occurrence Handle1:CAS:528:DyaK2MXivFKgsrs%3D Occurrence HandleA1994PE63100007

    PubMed  CAS  ISI  Google Scholar 

  13. J Lansbury (1968) ArticleTitleClinical appraisal of the activity index as a measure of rheumatoid activity Arthritis Rheum 11 599–604 Occurrence Handle5302852 Occurrence Handle1:STN:280:CCeH3cbps1w%3D

    PubMed  CAS  Google Scholar 

  14. T Pincus JA Summey SA Soraci SuffixJr KA Wallston NP Hummon (1983) ArticleTitleAssessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire Arthritis Rheum 26 1346–53 Occurrence Handle6639693 Occurrence Handle1:STN:280:BiuD2M3mt1Q%3D

    PubMed  CAS  Google Scholar 

  15. O Steinbrocker CH Traeger RC Batterman (1949) ArticleTitleTherapeutic criteria in rheumatoid arthritis JAMA 140 659–62 Occurrence HandleA1949UD23200001

    ISI  Google Scholar 

  16. S Kashiwazaki Y Ichikawa S Sugawara I Nagaya S Kawai M Hakota et al. (1996) ArticleTitleDetermination of the clinical optimal dose of L-377 (methotrexate capsule) for the treatment of rheumatoid arthritis (in Japanese) Jpn J Inflamm 16 483–58

    Google Scholar 

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Correspondence to Shunichi Shiozawa.

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Shiozawa, K., Tanaka, Y., Yoshihara, R. et al. Serum levels and pharmacodynamics of methotrexate and its metabolite 7-hydroxy methotrexate in Japanese patients with rheumatoid arthritis treated with 2-mg capsule of methotrexate three times per week. Mod Rheumatol 15, 405–409 (2005). https://doi.org/10.1007/s10165-005-0434-6

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  • DOI: https://doi.org/10.1007/s10165-005-0434-6

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