Methotrexate in rheumatoid arthritis is frequently effective, even if re-employed after a previous failure

Arthritis Research & Therapy
T KapralD Aletaha

Abstract

Effectiveness of therapy with individual disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA) is limited, and the number of available DMARDs is finite. Therefore, at some stage during the lengthy course of RA, institution of traditional DMARDs that have previously been applied may have to be reconsidered. In the present study we investigated the effectiveness of re-employed methotrexate in patients with a history of previous methotrexate failure (original course). A total of 1,490 RA patients (80% female, 59% rheumatoid factor positive) were followed from their first presentation, yielding a total of 6,470 patient-years of observation. We identified patients in whom methotrexate was re-employed after at least one intermittent course of a different DMARD. We compared reasons for discontinuation, improvement in acute phase reactants, and cumulative retention rates of methotrexate therapy between the original course of methotrexate and its re-employment. Similar analyses were peformed for other DMARDs. Methotrexate was re-employed in 86 patients. Compared with the original courses, re-employment was associated with a reduced risk for treatment termination because of ineffectiveness (P = 0.02, by McNemar test...Continue Reading

References

Sep 1, 1988·Clinical Rheumatology·T D Spector, D L Scott
Mar 28, 1985·The New England Journal of Medicine·M E WeinblattD E Trentham
Jan 1, 1994·Scandinavian Journal of Rheumatology. Supplement·P Emery
Apr 1, 1994·Arthritis and Rheumatism·F WolfeM A Cathey
Jun 8, 2001·QJM : Monthly Journal of the Association of Physicians·M L GroveM F Shadforth
Apr 16, 2003·Annals of the Rheumatic Diseases·D AletahaJ S Smolen
Oct 9, 2003·Annals of the Rheumatic Diseases·M FlendrieP L C M van Riel
Oct 9, 2003·Annals of the Rheumatic Diseases·M E Weinblatt
Dec 16, 2003·Arthritis and Rheumatism·Kurt RedlichJosef S Smolen
Oct 4, 2005·Arthritis and Rheumatism·Josef S SmolenEdward Keystone
Apr 12, 2013·Clinical and Experimental Immunology·C M U Hilkens, J D Isaacs

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Citations

Mar 21, 2018·The Annals of Pharmacotherapy·Brandon K Martinez, C Michael White
Jun 12, 2014·The Cochrane Database of Systematic Reviews·Maria Angeles Lopez-OlivoMaria E Suarez-Almazor
May 20, 2020·The Annals of Pharmacotherapy·Yuani M RomanC Michael White
Nov 3, 2016·The Journal of Rheumatology·Jeffrey R CurtisMichael Schiff

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Methods Mentioned

BETA
ESR

Software Mentioned

SPSS
Statistical Package for the Social Sciences ( SPSS

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