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Accelerated nodulosis and systemic manifestations during methotrexate therapy for rheumatoid arthritis

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dc.creatorAnaya, Juan-Manuelspa
dc.creatorSany, J.spa
dc.creatorCombe, Bspa
dc.creatorDidry, Cspa
dc.creatorGutiérrez Peláez, Miguel
dc.date.accessioned2020-08-19T14:44:38Z
dc.date.available2020-08-19T14:44:38Z
dc.date.created1993spa
dc.description.abstractObjectives: Methotrexate is successfully used in the treatment of arthritis but little is known about its effects on extra-articular manifestations of rheumatoid arthritis. We focused this work on the incidence and clinical course of extra-articular manifestations during long-term treatment with methotrexate.Methods: The effect of methotrexate on extra-articular manifestations was investigated in 176 patients with rheumatoid arthritis who had obtained, in a prospective study, a good clinical response to methotrexate (10 mg/week) taken for 33 months (range 4-68).Results: Before taking methotrexate, 44 patients (25.1%) had extra-articular manifestations: nodules (n = 40) and vasculitis (n = 9). With methotrexate, nodulosis and vasculitis were stable in 31 cases, improved in 3 and worsened in 10 (23%). Among the 132 patients without extra-articular manifestations before methotrexate therapy, 15 (11%) developed accelerated nodulosis preferentially located on the fingers, 7 had a vasculitis and 3 a pericarditis during methotrexate therapy. Extra-articular manifestations occurred between 1 and 24 months of initiating methotrexate therapy. Rheumatoid factor was positive in 88% of the patients with extra-articular manifestations. No relationship was noted between extra-articular manifestations and HLA type or antinuclear antibodies. In 3 out of 4 patients who developed accelerated nodulosis while taking methotrexate, the addition of hydroxychloroquine (400 mg/day) resulted in a significant reduction in the number and size of the nodules within 3 to 10 months after starting combined therapy.Conclusion: These data suggest that methotrexate is not effective in the treatment of extra-articular manifestations in rheumatoid arthritis and that nodulosis may occur in about 11% of patients taking methotrexate therapy for rheumatoid arthritis. The combination of hydroxychloroquine and methotrexate may have a beneficial effect on nodulosis that needs to be evaluated.eng
dc.format.mimetypeapplication/pdf
dc.identifier.issnISSN: 1165-0478
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/27919
dc.language.isoengspa
dc.publisherNational Center for Biotechnology Informationspa
dc.relation.citationEndPage160
dc.relation.citationIssueNo. 3
dc.relation.citationStartPage153
dc.relation.citationTitleThe European journal of medicine
dc.relation.citationVolumeVol. 2
dc.relation.ispartofThe European journal of medicine, ISSN: 1165-0478, Vol.2, No.3 (1993); pp. 153-160spa
dc.relation.urihttps://pubmed.ncbi.nlm.nih.gov/8261056/spa
dc.rights.accesRightsinfo:eu-repo/semantics/closedAccess
dc.rights.accesoBloqueado (Texto referencial)spa
dc.sourceThe European journal of medicinespa
dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subject.keywordMethotrexatespa
dc.subject.keywordVasculitisspa
dc.titleAccelerated nodulosis and systemic manifestations during methotrexate therapy for rheumatoid arthritisspa
dc.title.TranslatedTitleNódulosis acelerada y manifestaciones sistémicas durante el tratamiento con metotrexato para la artritis reumatoidespa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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