Methotrexate in rheumatoid arthritis: a 2 year experience at a university hospital in Pakistan.
Identifieur interne : 002718 ( Main/Exploration ); précédent : 002717; suivant : 002719Methotrexate in rheumatoid arthritis: a 2 year experience at a university hospital in Pakistan.
Auteurs : A A Ali ; M P Iqbal ; M A Hussain ; N. Mehboobali ; J A Beg ; M H RahbarSource :
- JPMA. The Journal of the Pakistan Medical Association [ 0030-9982 ] ; 1998.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Antirhumatismaux (usage thérapeutique), Association de médicaments, Chloroquine (usage thérapeutique), Femelle, Humains, Hôpitaux universitaires, Mâle, Méthotrexate (usage thérapeutique), Or (usage thérapeutique), Polyarthrite rhumatoïde (diagnostic), Polyarthrite rhumatoïde (traitement médicamenteux), Pénicillamine (usage thérapeutique), Résultat thérapeutique, Sujet âgé, Sulfasalazine (usage thérapeutique), Études de suivi, Études rétrospectives.
- MESH :
- diagnostic : Polyarthrite rhumatoïde.
- traitement médicamenteux : Polyarthrite rhumatoïde.
- usage thérapeutique : Antirhumatismaux, Chloroquine, Méthotrexate, Or, Pénicillamine, Sulfasalazine.
- Adulte, Adulte d'âge moyen, Association de médicaments, Femelle, Humains, Hôpitaux universitaires, Mâle, Résultat thérapeutique, Sujet âgé, Études de suivi, Études rétrospectives.
English descriptors
- KwdEn :
- Adult, Aged, Antirheumatic Agents (therapeutic use), Arthritis, Rheumatoid (diagnosis), Arthritis, Rheumatoid (drug therapy), Chloroquine (therapeutic use), Drug Therapy, Combination, Female, Follow-Up Studies, Gold (therapeutic use), Hospitals, University, Humans, Male, Methotrexate (therapeutic use), Middle Aged, Penicillamine (therapeutic use), Retrospective Studies, Sulfasalazine (therapeutic use), Treatment Outcome.
- MESH :
- chemical , therapeutic use : Antirheumatic Agents, Chloroquine, Gold, Methotrexate, Penicillamine, Sulfasalazine.
- diagnosis : Arthritis, Rheumatoid.
- drug therapy : Arthritis, Rheumatoid.
- Adult, Aged, Drug Therapy, Combination, Female, Follow-Up Studies, Hospitals, University, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome.
Abstract
In this study we report our two years experience of methotrexate (MTX) in the management of rheumatoid arthritis (RA) at the Aga Khan University Hospital, Karachi. We studied the clinical course of 124 RA patients. The mean age was 44 +/- 11 years (range 19-72) and mean duration of RA was 5 +/- 4 years (range 0.3-25). Female to male ratio was 10:2.4 (100F:24M). All of them were diagnosed according to the criteria set by American Rheumatism Association. The mean value of ESR was 60 +/- 30 (Range 3-128). Fifty one percent had severe disease (> 10 joints involved and evidence of erosions and deformities). Twenty-one patients had extra-articular manifestations. None of them had received MTX previously. Their kidney and liver functions were assessed to be normal. Patients were divided into two groups. One group (n = 92) received MTX (7.5-10 mg/week) as initial treatment, while the other group (n = 32) was given other disease modifying anti-rheumatic drugs (penicillamine, salazopyrin, gold, or chloroquine) followed by MTX. Assessment of the treatment outcome and development of any adverse reactions was carried out at 3-month interval over an average period of 1 year. Assessment of the treatment outcome in the group which received MTX as initial drug revealed the response to be excellent in 13%, good in 70%, fair in 11% and variable in 4%. In the group which received MTX as second-line of therapy, 59% of the patients had the response from good to excellent, while 25% of the patients exhibited poor to fair response. Regarding side-effects of MTX treatment, 57% exhibited none, while 35% had nausea and vomiting. Alopecia was the next common toxicity in these patients. Two individuals had abnormal liver function tests (value twice more than normal), while one developed lung fibrosis. MTX despite its adverse effects in some of the patients is still an effective, well tolerated and inexpensive disease modifying drug in RA.
PubMed: 9610077
Affiliations:
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Le document en format XML
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<term>Arthritis, Rheumatoid (drug therapy)</term>
<term>Chloroquine (therapeutic use)</term>
<term>Drug Therapy, Combination</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Gold (therapeutic use)</term>
<term>Hospitals, University</term>
<term>Humans</term>
<term>Male</term>
<term>Methotrexate (therapeutic use)</term>
<term>Middle Aged</term>
<term>Penicillamine (therapeutic use)</term>
<term>Retrospective Studies</term>
<term>Sulfasalazine (therapeutic use)</term>
<term>Treatment Outcome</term>
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<term>Chloroquine (usage thérapeutique)</term>
<term>Femelle</term>
<term>Humains</term>
<term>Hôpitaux universitaires</term>
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<term>Sulfasalazine (usage thérapeutique)</term>
<term>Études de suivi</term>
<term>Études rétrospectives</term>
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<front><div type="abstract" xml:lang="en">In this study we report our two years experience of methotrexate (MTX) in the management of rheumatoid arthritis (RA) at the Aga Khan University Hospital, Karachi. We studied the clinical course of 124 RA patients. The mean age was 44 +/- 11 years (range 19-72) and mean duration of RA was 5 +/- 4 years (range 0.3-25). Female to male ratio was 10:2.4 (100F:24M). All of them were diagnosed according to the criteria set by American Rheumatism Association. The mean value of ESR was 60 +/- 30 (Range 3-128). Fifty one percent had severe disease (> 10 joints involved and evidence of erosions and deformities). Twenty-one patients had extra-articular manifestations. None of them had received MTX previously. Their kidney and liver functions were assessed to be normal. Patients were divided into two groups. One group (n = 92) received MTX (7.5-10 mg/week) as initial treatment, while the other group (n = 32) was given other disease modifying anti-rheumatic drugs (penicillamine, salazopyrin, gold, or chloroquine) followed by MTX. Assessment of the treatment outcome and development of any adverse reactions was carried out at 3-month interval over an average period of 1 year. Assessment of the treatment outcome in the group which received MTX as initial drug revealed the response to be excellent in 13%, good in 70%, fair in 11% and variable in 4%. In the group which received MTX as second-line of therapy, 59% of the patients had the response from good to excellent, while 25% of the patients exhibited poor to fair response. Regarding side-effects of MTX treatment, 57% exhibited none, while 35% had nausea and vomiting. Alopecia was the next common toxicity in these patients. Two individuals had abnormal liver function tests (value twice more than normal), while one developed lung fibrosis. MTX despite its adverse effects in some of the patients is still an effective, well tolerated and inexpensive disease modifying drug in RA.</div>
</front>
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<name sortKey="Hussain, M A" sort="Hussain, M A" uniqKey="Hussain M" first="M A" last="Hussain">M A Hussain</name>
<name sortKey="Iqbal, M P" sort="Iqbal, M P" uniqKey="Iqbal M" first="M P" last="Iqbal">M P Iqbal</name>
<name sortKey="Mehboobali, N" sort="Mehboobali, N" uniqKey="Mehboobali N" first="N" last="Mehboobali">N. Mehboobali</name>
<name sortKey="Rahbar, M H" sort="Rahbar, M H" uniqKey="Rahbar M" first="M H" last="Rahbar">M H Rahbar</name>
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