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© 1989 British Society for Rheumatology

other

CLINICAL CONUNDRUM

A patient with seropositive rheumatoid arthritis who has previoasly failed or who has had adverse reactions on gold, penicillamine, chloroquibe and salazopyrine is now under reasonable but not complete control on methotrexate. She has been maintained on this treatment with minor variations in dosage over the last 3 years. What sort of monitoring should be undertaken at this stage and in particular should she have liver biopsles? Can she be kept on the treatment regimen indefinitely? If not, what alternatives should be considered?


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