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© 1995 British Society for Rheumatology

Adverse Events in Methotrexate-Treated Rheumatoid Arthritis Patients

D. M. Sandoval1, G. S. Alarcón1 and S. L. Morgan2

1 Divisions of Clinical Immunology and Rheumatology, Departments of Medicine University of Alabama at Birmingham Birmingham, AL, USA
2 Clinical Nutrition Sciences, Departments of Medicine, Nutrition Sciences, University of Alabama at Birmingham Birmingham, AL, USA

Correspondense to: G. S. Alarcón, UAB Station/MEB 615, 1813 6th Avenue South, Birmingham, AL 35294, USA.


  Abstract

Methotrexate (MTX) is an antifolate that has been in use for the treatment of rheumatoid arthritis (RA) since the early 1980s. Its efficacy has been clearly documented [1–4] and its administration early in the course of the disease is now generally accepted [5]. Side-effects from low weekly pulse MTX have been reported [1–6] and it was our initial experience that toxicity, rather than lack of efficacy, was the major factor limiting its clinical use [7]. However, when compared with other disease-modifying antirheumatic drugs, its toxicity appears to be comparable to that of antimalarials [8, 9]. The purpose of this paper is to discuss the possible mechanisms responsible for toxicity due to MTX used at low weekly pulse doses for the treatment of RA, as well as the different toxic manifestations reported in the literature.

KEY WORDS: Rheumatoid arthritis, Treatment, Methotrexate, Toxicity


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