Discipline of Clinical Pharmacology, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
Br J Clin Pharmacol. 2019 Oct;85(10):2228-2234. doi: 10.1111/bcp.14057. Epub 2019 Aug 9.
Methotrexate at low doses (5-25 mg/week) is first-line therapy for rheumatoid arthritis. However, there is inter- and intrapatient variability in response, with contribution of variability in concentrations of active polyglutamate metabolites, associated with clinical efficacy and toxicity. Prescribing remains heterogeneous across population groups, disease states and regimens. This review examines current knowledge of dose-response of oral methotrexate in the setting of rheumatoid arthritis, and how this could help inform dosage regimens.
甲氨蝶呤低剂量(5-25 毫克/周)是类风湿关节炎的一线治疗药物。然而,在反应中存在个体间和个体内的差异,其与活性多聚谷氨酸代谢物浓度的差异有关,而这些差异与临床疗效和毒性有关。在不同人群、疾病状态和方案中,处方仍然存在异质性。这篇综述检查了目前在类风湿关节炎背景下口服甲氨蝶呤的剂量反应知识,以及这如何帮助确定剂量方案。