Sneller M C, Hoffman G S, Talar-Williams C, Kerr G S, Hallahan C W, Fauci A S
Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.
Arthritis Rheum. 1995 May;38(5):608-13. doi: 10.1002/art.1780380505.
To determine the efficacy of low-dose methotrexate (MTX) plus prednisone in the treatment of Wegener's granulomatosis (WG).
An open-label study of weekly low-dose MTX plus prednisone for the treatment of WG was performed. Forty-two patients who did not have immediately life-threatening disease were enrolled into the study. Outcome was determined by clinical characteristics and pathologic, laboratory, and radiographic findings.
Weekly administration of MTX and prednisone resulted in remission of disease in 30 of the 42 patients (71%). The median time to remission was 4.2 months. The estimated median time to relapse for all patients in whom remission was achieved was 29 months. Eight patients who had relapses were treated with a second course of MTX plus prednisone, and a second remission was induced in 6 of the 8 (75%).
Weekly low-dose MTX was shown in this study to be an acceptable alternative form of therapy for selected patients with WG who do not have immediately life-threatening disease or who have developed serious cyclophosphamide-associated toxicity.
确定低剂量甲氨蝶呤（MTX）联合泼尼松治疗韦格纳肉芽肿（WG）的疗效。
开展一项关于每周使用低剂量MTX联合泼尼松治疗WG的开放标签研究。42例无即刻危及生命疾病的患者纳入研究。通过临床特征以及病理、实验室和影像学检查结果来判定疗效。
42例患者中，30例（71%）经每周给予MTX和泼尼松后病情缓解。缓解的中位时间为4.2个月。所有实现病情缓解的患者估计复发的中位时间为29个月。8例复发患者接受第二疗程的MTX联合泼尼松治疗，其中6例（75%）再次诱导缓解。
本研究表明，对于无即刻危及生命疾病或已出现严重环磷酰胺相关毒性的特定WG患者，每周低剂量MTX是一种可接受的替代治疗方式。
