Skip Navigation


Rheumatology Advance Access originally published online on August 15, 2003
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
43/2/143    most recent
keg466v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (20)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Saravanan, V.
Right arrow Articles by Kelly, C. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Saravanan, V.
Right arrow Articles by Kelly, C. A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Rheumatology 2004; 43: 143-147
© British Society for Rheumatology 2003; all rights reserved

Viewpoint

Reducing the risk of methotrexate pneumonitis in rheumatoid arthritis

V. Saravanan1 and C. A. Kelly2

1Department of Rheumatology, Freeman Hospital, Newcastle-upon-Tyne and 2Department of Medicine and Rheumatology, Queen Elizabeth Hospital, Gateshead, UK.

Correspondence to: V. Saravanan, Department of Rheumatology, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK. E-mail: saravana_uk@yahoo.co.uk

The first 150 words of the full text of this article appear below.

Methotrexate (MTX) is the most commonly used disease-modifying drug (DMARD) in rheumatoid arthritis (RA) [1]. It is a main anchor drug in many combination regimes with conventional DMARDs and biological agents. It has the longest drug-survival time and a good benefit/toxicity ratio [2, 3]. However, toxicity is a major reason for MTX withdrawal in RA [3]. Pneumonitis is the reason for withdrawal of MTX in 1 in 108 patient-years compared with 1 in 35 patient-years for hepatic toxicity and 1 in 58 patient-years for neutropenia [3]. There are guidelines for effective monitoring of the hepatic and haematological toxicity of MTX [4, 5]. Pneumonitis following MTX is a potentially fatal hypersensitivity reaction and is far less predictable than hepatic and haematological toxicity. Current guidelines [4, 5] advise a pretreatment chest radiograph (CXR), though there are wide . . . [Full Text of this Article]

Prevalence and pathogenesis of methotrexate pneumonitis

Risk factors

Clinical features

Investigations

Treatment

Prognosis

Chronic effects of MTX

Which RA patients should be given methotrexate?

What baseline tests are useful prior to methotrexate?

Proposal

Conflict of interest


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Rheumatology (Oxford)Home page
K. Collins, H. Aspey, A. Todd, V. Saravanan, M. Rynne, and C. Kelly
Methotrexate pneumonitis precipitated by switching from oral to parenteral administration
Rheumatology, January 1, 2008; 47(1): 109 - 110.
[Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
C. Kelly and J. Hamilton
What kills patients with rheumatoid arthritis?
Rheumatology, February 1, 2007; 46(2): 183 - 184.
[Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
V. Saravanan and C. A. Kelly
Reply to comment on 'Drug-related pulmonary problems in patients with rheumatoid arthritis' by Yazici and Yazici and 'Pulmonary adverse events with Leflunomide--myth or reality?' by Balakrishnan and Dasgupta
Rheumatology, February 1, 2007; 46(2): 372 - 373.
[Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
V. Saravanan and C. Kelly
Drug-related pulmonary problems in patients with rheumatoid arthritis
Rheumatology, July 1, 2006; 45(7): 787 - 789.
[Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
A. R. Clewes and J. K. Dawson
Reducing the risk of methotrexate pneumonitis in rheumatoid arthritis
Rheumatology, August 1, 2004; 43(8): 1059 - 1060.
[Full Text] [PDF]