Treatment of rheumatoid arthritis with higher dose intravenous methotrexate.

A pilot study evaluated intravenous methotrexate (MTX) (initial dose 40 mg/m2; final dose, 26 mg/m2), weekly for 12 weeks in 10 patients with rheumatoid arthritis who failed oral MTX. Statistically significant differences were noted for all the response variables examined: joint count (p = 0.0017), morning stiffness (p = 0.014), global assessment (patient, p = 0.0032, physician, p = 0.029), Arthritis Impact Measurement Scale (p = 0.0004), erythrocyte sedimentation rate (p = 0.012), grip strength (right p = 0.044, left p = 0.011). All 7 patients who completed the 12-week treatment period fulfilled the predetermined criteria for response. Intravenous MTX at these doses has potential efficacy in this patient group.