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Methotrexate (MTX) is the anchor drug in treatment of patients with rheumatoid arthritis (RA)1 2 and may reduce levels of rheumatoid factor (RF).3 4 Moreover, treatment of patients with RA with biological agents—that is, tumour necrosis factor α (TNFα) antagonist, is presently combined with MTX to reduce the formation of antibodies against the biological agents.
We describe two patients with known latent autoimmune diabetes of the adult and concomitant RA who showed a marked decline in anti-glutamic acid decarboxylase (GAD) titres after receiving MTX treatment.
The first case is a 68-year-old woman who has had anti-GAD positive diabetes since the age of 47, which was poorly controlled, without hypertension and a body mass …
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Competing interests: None declared.