Autoimmunity reviews
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Autoimmunity reviews · Nov 2014
ReviewClinical characteristics and risk factors for low dose methotrexate toxicity: a cohort of 28 patients.
Low dose (10-25 mg/week) methotrexate is widely used for the management of systemic inflammatory diseases, and is considered to be relatively safe. Toxicity due to low dose MTX has been reported but is poorly characterized. We describe the clinical features, risk factors, and outcomes of low dose MTX toxicity in a large case series at our center. ⋯ Low-dose MTX toxicity can be life threatening, mainly due to myelosuppression. There is no rationale for MTX therapeutic drug monitoring in the setting of low-dose toxicity.
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Autoimmunity reviews · Nov 2014
ReviewMethotrexate for the treatment of rheumatoid arthritis in the biologic era: still an "anchor" drug?
The improvement of rheumatoid arthritis (RA) management has been strictly related to methotrexate (MTX) long-term effectiveness, safety profile and its widespread use in clinical practice over the last decades. According to the results of several head-to-head comparative trials against other synthetic DMARDs, MTX has been recognised as the "anchor drug" for the treatment of RA at the end of the 1990s. ⋯ This review first analyses data supporting the evolution of MTX towards the role of "anchor drug" for RA in the pre-biologic era. We will then examine how the introduction and progressive spreading of biological agents could have modified the central role of MTX in the approach to RA.