METHOTREXATE AS THE INITIAL 2ND-LINE DISEASE-MODIFYING AGENT IN THE TREATMENT OF RHEUMATOID-ARTHRITIS PATIENTS

Objective. To assess the efficacy and toxicity profile of methotrexate (MTX) as the initial second-line disease modifying anti-rheumatic dru g (DMARD) in rheumatoid arthritis (RA). Methods. This was an observati onal retrospective cohort study comparing 28 patients who were treated with MTX as the first DMARD (MTX cases) and 55 matched patients treat ed with MTX after other DMARDs (MTX controls). Results. The follow-up time was identified in the two groups: 19.4 +/- 14 months (2 - 56) for the MTX cases and 21.8 +/- 15.3 months (3 - 87) for MTX controls (NS) . MTX efficacy was the same in the two groups, except for a higher inc idence of remission in the MTX cases (8/28, 28.6% versus 5/55, 9.1%, p = 0.028). The toxicity profiles, frequencies, and reasons for MTX wit hdrawals were similar in the two groups. Conclusion. The results obtai ned in the study suggest a benefit from MTX prescribed as an initial s econd-line agent in the treatment of RA, but studies involving a large r number of patients are needed.