Methotrexate Treatment of Rheumatoid Arthritis

Excerpt

Controlled studies showing the effectiveness of methotrexate (1-3) in the treatment of rheumatoid arthritis confirm earlier anecdotal reports (4, 5). For the most part, these studies have been short-term and have uniformly described minimal toxicity. The awareness of this favorable therapeutic-to-toxic ratio of methotrexate in rheumatoid arthritis is reflected in cursory surveys that suggest that most rheumatologists are using this drug to treat patients with rheumatoid arthritis even though it is sanctioned for such use.

The limited toxicity seen in short-term studies is undoubtedly related to patient selection, which eliminates those at high risk for the development of adverse effects.