Biasi D, Caramaschi P, Carletto A, Botto M, Codella O, Pacor M L, Bambara L M
Istituto di Patologia speciale medica, Università, Verona.
Recenti Prog Med. 1992 Jul-Aug;83(7-8):473-6.
30 patients affected by Rheumatoid Arthritis were treated with Methotrexate (5-7.5 mg/weekly) per os and followed up for at least 12 months; 10 patients had a further control at 24 months. 27 subjects were also on corticosteroid and 2 patients did not stop the therapy with second line drugs. Sulindac was allowed. 3 months later it was observed a significant reduction in the number of affected joints, in the duration of morning stiffness, in the dose of steroid and an improvement of the laboratory investigations indicating the activity of the disease. In the following 12 months, in the 25 subjects still in the study, there was a further clinical improvement. In 24-months follow-up, side effects were present in 17 patients (56.7%); only in 4 cases it was necessary to stop therapy with Methotrexate (3 cases for hepatotoxicity, 1 case for leukocytopenia and stomatitis). 3 subjects did not respond to therapy and 3 patients interrupted for psychological distress. This study confirms the efficacy of Methotrexate at low doses in the treatment of Rheumatoid Arthritis and the modest incidence of severe side effects.
30例类风湿关节炎患者口服甲氨蝶呤（5 - 7.5毫克/周）进行治疗，并随访至少12个月；10例患者在24个月时进行了进一步的检查。27名受试者同时服用皮质类固醇，2例患者未停用二线药物。允许使用舒林酸。3个月后，观察到受累关节数量显著减少，晨僵持续时间缩短，类固醇剂量降低，且表明疾病活动的实验室检查结果有所改善。在接下来的12个月里，仍在研究中的25名受试者临床症状进一步改善。在24个月的随访中，17例患者（56.7%）出现了副作用；仅4例患者因副作用需要停用甲氨蝶呤（3例因肝毒性，1例因白细胞减少和口腔炎）。3名受试者对治疗无反应，3例患者因心理困扰中断治疗。本研究证实了低剂量甲氨蝶呤治疗类风湿关节炎的疗效以及严重副作用的发生率较低。
