EDITORIAL
Optimal use of methotrexate: the advantages of tight control
1 Department of Rheumatology & Clinical Immunology, UMC Utrecht, Utrecht, the Netherlands
2 Department of Rheumatology and Immunology, Brigham & Women’s Hospital, Boston, MA, USA
Correspondence to:
Professor J W J Bijlsma, UMC Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands; j.w.j.bijlsma@umcutrecht.nl
Accepted 24 August 2007
The CAMERA study shows that using methotrexate in a tight control setting might lead to considerable improvement in disease activity in early rheumatoid arthritisSee linked article p 1443
| The first 150 words of the full text of this article appear below. |
The outlook for patients who are in 2007 newly diagnosed with rheumatoid arthritis has improved dramatically.1 Important elements in this improvement are: (1) the concept of a "window of opportunity": treat early and treat effectively;2 (2) early use of disease modifying anti-rheumatic drugs (DMARDs);3 (3) combination treatment, including glucocorticoids;4 5 (4) the use of biologicals;6 and (5) optimising therapy to the individual patient.
The CAMERA study reported in this issue by the Utrecht group See pages 1443 deals with this last item: optimising therapy to the individual patient.7 In this randomised controlled trial the drug treatment given to patients with early rheumatoid arthritis was the same in both groups, but the frequency and tightness of control were different. This report has some important messages that merit further comment:
1. The goal of tight control is feasible with the anchor drug methotrexate in a much larger proportion of patients than previously thought.
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Relevant Article
- Intensive treatment with methotrexate in early rheumatoid arthritis: aiming for remission. Computer Assisted Management in Early Rheumatoid Arthritis (CAMERA, an open-label strategy trial)
- S M M Verstappen, J W G Jacobs, M J van der Veen, A H M Heurkens, Y Schenk, E J ter Borg, A A M Blaauw, J W J Bijlsma, and on the behalf of the Utrecht Rheumatoid Arthritis Cohort study group
Ann Rheum Dis 2007 66: 1443-1449.[Abstract] [Full Text] [PDF]
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