Methotrexate and Rheumatoid Arthritis

Excerpt

To the Editors: In their recent study, Jeurissen and colleagues (1) compared the efficacy of methotrexate with that of azathioprine in the treatment of patients with well-established rheumatoid arthritis. These investigators should be applauded for their study design, which allowed the discrimination of radiologic change over time. In this study, investigators obtained a radiograph before therapy, one at 6 months, and then every 6 to 12 months thereafter. Scott and colleagues (2) have shown that even when inflammation is adequately controlled (as measured by reduction in both the erythrocyte sedimentation rate and the number of tender joints), radiologic damage will