EDITORIAL
Methotrexate: the gold standard without standardisation
1 Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
2 Division of Rheumatology, Department of Musculoskeletal Sciences, UZ Gasthuisberg, KU Leuven, Belgium
Correspondence to:
Professor R Westhovens, Division of Rheumatology, Department of Musculoskeletal Sciences, UZ Gasthuisberg, KU Leuven, B-3000 Leuven, Belgium; rene.westhovens@uz.kuleuven.ac.be
Accepted 23 February 2009
| The first 150 words of the full text of this article appear below. |
Even in the current era of biological targeted therapies, methotrexate (MTX) remains the initial preferred antirheumatic drug and is widely prescribed for patients with rheumatoid arthritis (RA). The combination of its perceived efficacy, acceptable safety profile and low cost, as well as decades of clinical experience with its use that have been accumulated by current and previous generations of rheumatologists, make MTX the cornerstone of treatment for RA and the anchor drug for combination with each of the newer biological agents.
Four papers in this journal1–4 provide general guidance for the use of MTX, its optimal dose and route of administration and its potential toxicity (see articles on pages 1086, 1094, 1100 and 1105). This "3E Initiative," supported by an unrestricted educational grant from Abbott, began with an extensive systematic literature review (Evidence) that was discussed by each of 17 national scientific committees (Expertise). These national
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Relevant Articles
- Optimal dosage and route of administration of methotrexate in rheumatoid arthritis: a systematic review of the literature
- K Visser and D van der Heijde
Ann Rheum Dis 2009 68: 1094-1099.[Abstract] [Full Text] [PDF]
- Long-term safety of methotrexate monotherapy in patients with rheumatoid arthritis: a systematic literature research
- C Salliot and D van der Heijde
Ann Rheum Dis 2009 68: 1100-1104.[Abstract] [Full Text] [PDF]
- Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative
- K Visser, W Katchamart, E Loza, J A Martinez-Lopez, C Salliot, J Trudeau, C Bombardier, L Carmona, D van der Heijde, J W J Bijlsma, D T Boumpas, H Canhao, C J Edwards, V Hamuryudan, T K Kvien, B F Leeb, E M Martín-Mola, H Mielants, U Müller-Ladner, G Murphy, M Østergaard, I A Pereira, C Ramos-Remus, G Valentini, J Zochling, and M Dougados
Ann Rheum Dis 2009 68: 1086-1093.[Abstract] [Full Text] [PDF]
- Efficacy and toxicity of methotrexate (MTX) monotherapy versus MTX combination therapy with non-biological disease-modifying antirheumatic drugs in rheumatoid arthritis: a systematic review and meta-analysis
- W Katchamart, J Trudeau, V Phumethum, and C Bombardier
Ann Rheum Dis 2009 68: 1105-1112.[Abstract] [Full Text] [PDF]
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- Ann Rheum Dis Online, 7 Jul 2009 [Full text]
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