Kimura E, Oga S, Pereira R M R
Department of Pharmacy and Pharmacology, State University of Maringá, Paraná, Brazil.
J Clin Pharm Ther. 2007 Dec;32(6):579-84. doi: 10.1111/j.1365-2710.2007.00860.x.
To compare the pharmacokinetics and report on the clinical effects of methotrexate (MTX) in patients with juvenile idiopathic arthritis (JIA), receiving long-term MTX or MTX plus chloroquine (CQ).
The pharmacokinetics of MTX, clinical characteristics (morning stiffness, joint tenderness and number of swollen joints) and biochemical markers (A-amyloid substance, C-reactive protein, erythrocyte sedimentation rate, fibrinogen and alpha-glycoprotein acid, alanine transaminase and aspartate transaminase) of the JIA patients were determined. Eight patients were treated with MTX (0.15 mg/kg) and another eight with MTX (0.15 mg/kg) plus CQ (4 mg/kg) for at least 6 months.
All patients had polyarticular involvement and the clinical characteristics and biochemical markers were similar for the two groups. The pharmacokinetics of MTX were also similar with the Cmax and AUC values being 455.00 +/- 101.00 nm and 1469.92 +/- 299.77 nm/h for MTX group and 425.00 +/- 169.60 nm and 1560.73 +/- 615.49 nm/h for MTX plus CQ group, respectively. The respective creatinine clearance was 117.95 +/- 12.58 for MTX group and 99.17 +/- 22.65 mL/min for MTX plus CQ.
The pharmacokinetics of MTX in JIA patients treated chronically with MTX are similar, with or without CQ co-treatment.
比较甲氨蝶呤（MTX）在接受长期MTX治疗或MTX联合氯喹（CQ）治疗的幼年特发性关节炎（JIA）患者中的药代动力学，并报告其临床疗效。
测定JIA患者的MTX药代动力学、临床特征（晨僵、关节压痛和肿胀关节数）及生化指标（A-淀粉样物质、C反应蛋白、红细胞沉降率、纤维蛋白原和α-糖蛋白酸、丙氨酸转氨酶和天冬氨酸转氨酶）。8例患者接受MTX（0.15mg/kg）治疗，另外8例接受MTX（0.15mg/kg）联合CQ（4mg/kg）治疗至少6个月。
所有患者均有多关节受累，两组的临床特征和生化指标相似。MTX的药代动力学也相似，MTX组的Cmax和AUC值分别为455.00±101.00nm和1469.92±299.77nm/h，MTX联合CQ组分别为425.00±169.60nm和1560.73±615.49nm/h。MTX组和MTX联合CQ组的肌酐清除率分别为117.95±12.58和99.17±22.65mL/min。
长期接受MTX治疗的JIA患者，无论是否联合CQ治疗，MTX的药代动力学相似。
