一项关于加拿大目前类风湿关节炎甲氨蝶呤处方实践的调查。
A Canadian survey of current methotrexate prescribing practices in rheumatoid arthritis.
作者信息
Collins D, Bellamy N, Campbell J
机构信息
Department of Medicine, University of Western Ontario, London, Canada.
出版信息
J Rheumatol. 1994 Jul;21(7):1220-3.
OBJECTIVE
To conduct a cross sectional survey of methotrexate (MTX) prescribing practices of Canadian rheumatologists in their treatment of rheumatoid arthritis (RA).
METHODS
A 15-item questionnaire was mailed to 197 rheumatologists with a 79% response rate after 3 mailings.
RESULTS
The usual starting dose was 7.5 mg/week (range = 2.5-15.0) and the usual maximum dose prescribed was 15 mg/week (range = 10-50); 81% routinely coadministered MTX and non-steroidal antiinflammatory drugs; 28% routinely used folic acid prophylaxis; 97% of respondents performed regular assessments of liver function. Only 17% requested a liver biopsy after a certain time and 23% after a certain cumulative dose. Sixty-two percent performed pre-MTX liver biopsy on patients with liver function abnormalities. Only 14% of respondents routinely performed pulmonary function tests. Ninety-one percent of respondents noted that 1-50% (mode = 10%) of patients refused to accept MTX therapy after it had been recommended, usually because of fear of side effects.
CONCLUSION
Despite potential toxicity, the majority of respondents used MTX in the treatment of adult RA.
目的
对加拿大风湿病学家治疗类风湿关节炎（RA）时甲氨蝶呤（MTX）的处方实践进行横断面调查。
方法
向197名风湿病学家邮寄了一份包含15个条目的问卷，经过3次邮寄后，回复率为79%。
结果
通常的起始剂量为7.5毫克/周（范围=2.5 - 15.0），规定的通常最大剂量为15毫克/周（范围=10 - 50）；81%的人常规联合使用MTX和非甾体抗炎药；28%的人常规使用叶酸预防；97%的受访者定期进行肝功能评估。只有17%的人在一定时间后要求进行肝活检，23%的人在达到一定累积剂量后要求进行肝活检。62%的人对肝功能异常的患者在使用MTX前进行肝活检。只有14%的受访者常规进行肺功能测试。91%的受访者指出，1 - 50%（众数=10%）的患者在被推荐使用MTX治疗后拒绝接受，通常是因为害怕副作用（不良反应）。
结论
尽管存在潜在毒性，但大多数受访者仍使用MTX治疗成人RA。
Zotero 插件