© 1989 British Society for Rheumatology
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PROSPECTIVE LONG TERM FOLLOW-UP OF METHOTREXATE THERAPY IN RHEUMATOID ARTHRITIS: TOXICITY, EFFICACY AND RADIOLOGICAL PROGRESSION
Rheumatic Disease Unit, University of Alberta Edmonton, Alberta, Canada
Correspondence to:
1Correspondence to: Dr. A. S. Russell, 9-112 Clinical Sciences Building, University of Alberta, Edmonton, Alberta T6G 2G3, Canada.
We followed all 128 patients started on methotrexate (MTX) for rheumatoid arthritis (RA) over a 4-year period. Forty-nine were followed for over 3 years. Forty-three patients discontinued treatment, 23 because of toxicity, 15 for inefficacy and five for other reasons. Forty-seven of the 75 followed on treatment for over 2 years had hand radiographs available before and after this treatment period. None showed improvement and 15 showed marked deterioration. Patients' acceptance of this therapy was good although most were noted objectively to have persistent disease activity. We would recommend that if MTX is to be used, a more aggressive approach be adopted to reduce not only the symptoms but the signs of active disease.
KEY WORDS: Disease-modifying antirheumatic drugs, Side effects, Radiographs, Haematology, Liver, Kidney
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