To overstate the importance of methotrexate in the contemporary management of rheumatoid arthritis (RA) would be difficult. During the last 15 years, methotrexate has simultaneously revolutionized and revitalized the treatment of patients with RA.13,38,57 Methotrexate, a drug that was seldom given in the early 1980s, is now the disease-modifying antirheumatic drug (DMARD) most commonly used to treat RA.13 Methotrexate was not approved by the FDA for use in RA until 1988; it is now not only the most commonly used but also the first prescribed DMARD by most rheumatologists in the United States for the treatment of RA.57 It has achieved this distinction because of both its efficacy and tolerability. Other currently available DMARDs offer sustained benefit (2 years) to only a small minority of RA patients 63,92 compared with sustained benefit in well over 50% of methotrexate-treated patients.43,45,63,87,92 The current therapeutic goal for all patients with RA is to produce a remission of the patient's disease 47; despite all of the significant improvements seen when methotrexate is used, it nevertheless rarely induces remissions.43,78,87 This article reviews the data on the efficacy and toxicity of methotrexate, discusses caveats for clinical use, examines the use of methotrexate in combination therapy, and speculates on the future use of methotrexate in RA.

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   |wiki=    Sante
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   |flux=    Main
   |étape=   Exploration
   |type=    RBID
   |clé=     ISTEX:70308C6604DFD0ED8E7FE1AC0BE788F5E8A9203F
   |texte=   METHOTREXATE USE IN RHEUMATOID ARTHRITIS
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