Nihon rinsho. Japanese journal of clinical medicine
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Review Comparative Study
[Methotrexate for the treatment of rheumatoid arthritis in Japan--much more still remains to be resolved].
Methotrexate(MTX) is an antifolic agent and has been widely used for RA since early 1980s. Since 1999 when MTX was approved as an antirheumatic drug in Japan, patients taking MTX has been increasing and about sixty thousands patients are estimated to be taking MTX for the treatment of RA. The highest efficacy relative to toxicity of MTX is supported by the highest retention rate among current DMARDs. ⋯ However, an upper limit of clinical dose of MTX (Rheumatrex) for RA is set to 8 mg weekly and this is a major problem because the majority of patients with active RA need higher doses for the suppression of arthritis. This matter needs an immediate solution. If MTX would be used aggressively for the early suppression of RA, informed consent regarding MTX dose and side effects including their earlier signs should be obtained, especially when patients are taking more than 8 mg weekly.