Anaya J M, Jorgensen C, Daurès J P, Combe B, Sany J
Service d'Immuno-Rhumatologie et Réadaptation Fonctionnelle, Centre Gui-de-Chauliac, Hôpital Saint-Eloi, Montpellier.
Rev Rhum Mal Osteoartic. 1992 Mar;59(3):181-7.
One hundred and ninety one patients with rheumatoid arthritis were included in an open prospective trial with the aim of evaluating the acceptability, efficacy and therapeutic maintenance levels of methotrexate. The mean treatment duration was 19 +/- 13.2 (3-58) months and the mean weekly dose of methotrexate 10.2 +/- 0.2 mg. Analysis of the 191 patients by intention to treat showed a statistically significant improvement in all clinical parameters as well as a significant fall in sedimentation rate with a corticosteroid-sparing effect. The therapeutic maintenance level of methotrexate was 73% at one year, 65% at 2 years and 46% at 5 years. Adverse reactions occurred in 71 patients (37.1%) including 30 who stopped methotrexate permanently as a result. With cautious and strict patient selection, methotrexate could be used in RA as basic treatment of first choice.
191例类风湿关节炎患者纳入一项开放性前瞻性试验，旨在评估甲氨蝶呤的可接受性、疗效及治疗维持水平。平均治疗时长为19±13.2（3 - 58）个月，甲氨蝶呤平均每周剂量为10.2±0.2毫克。按照意向性分析这191例患者，结果显示所有临床参数均有统计学意义的改善，血沉显著下降，且具有激素节省效应。甲氨蝶呤的治疗维持率1年时为73%，2年时为65%，5年时为46%。71例患者（37.1%）出现不良反应，其中30例因此永久停用甲氨蝶呤。经过谨慎且严格的患者筛选，甲氨蝶呤可作为类风湿关节炎的首选基础治疗药物。
