INFLUENCE OF METHOTREXATE ON RADIOGRAPHIC PROGRESSION IN RHEUMATOID-ARTHRITIS - A 60-MONTH PROSPECTIVE-STUDY

Objective: To evaluate if methotrexate (MTX) can slow disease progress ion, as determined radiographically, in comparison to other disease mo difying drugs in rheumatoid arthritis (RA) patients. Materials and met hods: Pairs of hand and wrist radiographs from 30 patients treated wit h MTX and 30 treated with D-penicillamine (DP) were evaluated blindly and separately by two radiologists (A and B) using reference radiograp hs for scoring. A scale scoring similar to Larsen's standard radiograp hs with minor modifications was used. The radiographs studied were obt ained at the beginning and 5 years after therapy in both groups. Resul ts: A significantly greater worsening was found in the DP-treated pati ents (p = 0.025), as compared to MTX patients. Methotrexate showed a s lower rate of disease progression than DP. Furthermore, in the MTX gro up 15 patients remained radiographically stable, 9 worsened and 6 were healed. In contrast, in the DP group 22 patients remained radiographi cally stable, 8 worsened and none improved. Conclusions: The rate of r adiographic progression in RA patients was lower in MTX-treated patien ts compared to those treated with DP. Six patients showed radiological improvement after MTX treatment. Therefore, it seems that MTX could b e considered a disease modifying drug.