Karger T, Rau R
Rheumaklinik am Evangelischen Fachkrankenhaus Ratingen.
Dtsch Med Wochenschr. 1988 May 27;113(21):839-46. doi: 10.1055/s-2008-1067731.
Methotrexate, 7.5-25.0 mg, was taken in a single weekly dose by 101 patients with chronic rheumatoid arthritis. In the course of treatment there was significant improvement in pain and mobility, as well as in the number of inflamed joints, strength of hand-grip (both hands), and use of steroids. There was a significant fall in erythrocyte sedimentation rate, and haemoglobin content rose significantly. Improvement occurred in 85% of patients; within this group 30% had a remission during treatment. There were 7% non-responders. Side effects were frequent: gastrointestinal symptoms in about 50%, loss of hair and stomatitis in 10-20%. In nine patients methotrexate had to be discontinued because of side effects, but in six of them the drug was taken again later on. Transaminases increased in 50% of patients. No clear-cut histological changes were found in the liver. It is concluded that low-dose methotrexate is effective in the long-term treatment of chronic rheumatoid arthritis.
101例慢性类风湿性关节炎患者每周单次服用甲氨蝶呤7.5 - 25.0毫克。在治疗过程中,疼痛、活动能力、炎症关节数量、握力(双手)以及类固醇的使用情况均有显著改善。红细胞沉降率显著下降,血红蛋白含量显著上升。85%的患者病情有所改善;在这组患者中,30%在治疗期间病情缓解。有7%的患者无反应。副作用很常见:约50%的患者出现胃肠道症状,10 - 20%的患者出现脱发和口腔炎。9例患者因副作用不得不停用甲氨蝶呤,但其中6例后来又重新使用该药物。50%的患者转氨酶升高。肝脏未发现明显的组织学变化。结论是低剂量甲氨蝶呤在慢性类风湿性关节炎的长期治疗中有效。