Treatment of Chronic Rheumatoid Arthritis with Low-Dose Methotrexate

Ten patients with chronic rheumatoid arthritis were treated with low-dose methotrexate (MTX) (7.5mg/week). All patients had been treated unsuccessfuly with other anti-rheumatoid drugs. The average age of the patients was 54 years old, and the average duration of the disease was 11.1 years at the time MTX therapy was initiated.In 8 of the 10 patients (80%) there were significant improvements by the usual measures of clinical efficacy after 6 weeks of the treatment, and improvement was evident in the Lansbury score. Compared with base line values, Lansbury score decreased after 6 weeks of the treatment (p<0.05), length of time of morning stiffness decreased after 12 weeks (p<0.05), and the number of the joint score decreased after 4 weeks (p<0.05). The ESR and CRP improved after 6 weeks (p<0.05). Although side effects of MTX were noted in 2 of the 10 patients (20%), which were elevated counts of liver function studies, they were tolerable after adjusment of the MTX dosage.We concluded that low-dose methotrexate is effective against chronic rheumatoid arthritis.