Methotrexate in Rheumatoid Arthritis

Editorials15 April 1989Methotrexate in Rheumatoid ArthritisFeedback on American College of Physicians GuidelinesPeter Tugwell, MD, Kathryn Bennett, MSc, Mary Bell, MD, Michael Gent, MDPeter Tugwell, MDSearch for more papers by this author, Kathryn Bennett, MScSearch for more papers by this author, Mary Bell, MDSearch for more papers by this author, Michael Gent, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-8-581 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe American College of Physicians (ACP) guidelines and the background paper on the use of methotrexate in rheumatoid arthritis published in this journal last year (1, 2) have stimulated useful discussions around a number of issues. Most of these issues were discussed by the ACP Clinical Efficacy Assessment Project subcommittee before the guidelines were published, but this editorial discusses some different perspectives.The feedback from the rheumatology community, with some exceptions arising from a concern about medico-legal implications, has been positive about the courage of the College in publishing guidelines for a drug before its approval for this use by...References1. Methotrexate in rheumatoid arthritis. Health and Public Policy Committee, American College of Physicians. Ann Intern Med. 1987;107:418-9. LinkGoogle Scholar2. TugwellBennettGent PKM. Methotrexate in rheumatoid arthritis. Ann Intern Med. 1987;107:358-66. LinkGoogle Scholar3. WeinblattCoblynFox MJD. Efficacy of low-dose methotrexate in rheumatoid arthritis. N Engl J Med. 1985;312:818-22. CrossrefMedlineGoogle Scholar4. AndersonWestO'DellViaClaypoolKotzin PSJCRB. Weekly pulse methotrexate in rheumatoid arthritis. 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Methotrexate in rheumatoid arthritis. Arthritis Rheum. 1988;31:305-14. CrossrefMedlineGoogle Scholar10. KremerLee JJ. A long-term prospective study of methotrexate in rheumatoid arthritis. Arthritis Rheum. 1988;31:577-84. CrossrefMedlineGoogle Scholar11. WilkesKremerMacKenzie RJA. Methotrexate and rheumatoid arthritis [Letter]. Ann Intern Med. 1989;110:88. LinkGoogle Scholar12. FurstWeinblatt DM. Methotrexate and rheumatoid arthritis [Letter]. Ann Intern Med. 1989;110:89. Google Scholar13. RoenigkAuerbachBergfeld HRW. A cooperative, prospective study of the effects of chemotherapy of psoriasis on liver biopsies. In: Cox AJ, Farber EM, eds. Psoriasis Proceedings: 2nd International Symposium. New York: Yorke Medical Books; 1977:243-8. Google Scholar14. WeinblattCoblynFraserHoldsworthFalchukTrentham MJPDKD. Long term prospective study of methotrexate in rheumatoid arthritis [Abstract]. Arthritis Rheum. 1986;29 (suppl 4): S76. Google Scholar15. GuyattSackettAdachi GDJ. A clinician's guide for conducting randomized trials in individual patients. Can Med Assoc J. 1988;139:497-503. MedlineGoogle Scholar16. FurstHaubFaulknerHoffman DRRJ. Pharmacokinetics of low-dose methotrexate in rheumatoid arthritis [Abstract]. Clin Pharmacol Ther. 1986;35:193. Google Scholar17. TeresiCromChoiMirroEvans MWKJW. Methotrexate bioavailability after oral and intramuscular administration in children. J Pediatrics. 1987;110:788-92. CrossrefMedlineGoogle Scholar18. NordstromWestAndersonSharp DSPJ. Pulse methotrexate therapy in rheumatoid arthritis [Letter]. Ann Intern Med. 1988;108:905. LinkGoogle Scholar19. WeinblattTrenthamFraser MDP. Long-term prospective trial of low-dose methotrexate in rheumatoid arthritis. Arthritis Rheum. 1988;31:167-75. CrossrefMedlineGoogle Scholar20. Inman W ed. Monitoring for Drug Safety. Boston: MTP Press; 1986:765pp. Google Scholar21. MullarkeyBlumensteinAndradeBaileyOlasonWetzel MBWGIC. Methotrexate in the treatment of corticosteroiddependent asthma. N Engl J Med. 1988;318:603-7. CrossrefMedlineGoogle Scholar22. JenkinsRooneyJonesBienenstockGoodacre RPDJR. Increased intestinal permeability in patients with rheumatoid arthritis: a side-effect of oral nonsteroidal anti-inflammatory drug therapy? Br J Rheumatol. 1987;26:103-7. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: McMaster University Hamilton, Ontario Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByRevisión sistemática del uso de metotrexato por vía parenteral en enfermedades reumáticasFolic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritisMortality in rheumatoid arthritis over the last fifty years: Systematic review and meta-analysisMortalité dans la polyarthrite rhumatoïde au cours des 50 dernières années : revue systématique et méta-analysePharmacologic Treatment of Immune Disorders and Specifically of Immune Ocular Inflammatory DiseaseNoncardiogenic Pulmonary Edema in Low-dose Oral Methotrexate TherapyFolic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritisNeurologic complications after total shoulder arthroplastyHEPATOTOXICITY OF CHEMOTHERAPEUTIC AND ONCOLOGIC AGENTSRenal Biopsy Specimens From Patients With Rheumatoid Arthritis and Apparently Normal Renal Function After Therapy With CyclosporineLow-dose oral methotrexate in refractory inflammatory bowel diseaseNon-steroidal anti-inflammatory drugs and slow-acting anti-rheumatic drugs in juvenile rheumatoid arthritisThe effect of food on the absorption of methotrexate sodium tablets in healthy volunteersPharmacology and General Therapeutic Principles of MethotrexateMethotrexate versus azathioprine in the treatment of rheumatoid arthritis. A forty-eight–week randomized, double-blind trialWeekly low-dose methotrexate therapy for cutaneous sarcoidosisDisease-modifying antirheumatic and immunoregulatory agentsAspirin, hydroxychloroquine, and hepatic enzyme abnormalities with methotrexate in rheumatoid arthritisResolve: Methotrexate is the drug of choice after NSAIDs in rheumatoid arthritisLow-dose cyclosporin versus placebo in patients with rheumatoid arthritisTHERAPEUTIC PROGRESS–REVIEW XXXVII: METHOTREXATE–AN IMMUNOMODULATOR WITH EXPANDING INDICATIONSAchieving consensus on an algorithm for the treatment of rheumatoid arthritis with methotrexateMethotrexate Therapy in Cutaneous SarcoidosisGuy F. Webster, MD, PhD, Linda K. Razsi, MD, Miguel Sanchez, MD, Jerome R. Shupack, MDNatural history and treatment decisions in rheumatoid arthritis revisited 15 April 1989Volume 110, Issue 8Page: 581-583KeywordsDrugsMethotrexateRheumatoid arthritisRheumatology Issue Published: 15 April 1989 PDF DownloadLoading ...