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Concomitant Use With Biologic Agents and DMARDs Other Than Methotrexate in RA, GPA, and MPA: Limited data are available on the safety of the use of biologic agents or DMARDs other than methotrexate in RA patients exhibiting peripheral B-cell depletion following treatment with Rituxan.
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Patel received fellowship training in internal medicine and rheumatology at Geisinger Medical Center, Danville, Pa.
ENBREL has been prescribed by doctors for more than a decade.
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Other drugs, such as salicylates, phenylbutazone, phenytoin, and sulfonamides, may increase methotrexate toxicity by displacing albumin-bound methotrexate.
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The Tight Control of Rheumatoid Arthritis (TICORA) study also suggests that an important means of achieving tight disease control is frequent review by specialists and prompt escalation of DMARD and steroid doses in response to increasing disease activity.
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All of the other authors have received grants or served as consultants to or members of speakers' bureaus sponsored by Centocor or other companies that manufacture treatments for rheumatoid arthritis.
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Ophthalmologist before starting MTX, and at least a yearly recheck afterwards.
Methotrexate (MTX) is an excellent, economical first-line DMARD used to treat a majority of RA patients.
Methotrexate may also be prescribed for people with CD who have “steroid-dependent” disease; this means that their bodies have become so used to treatment with corticosteroids for symptom relief that when they try to stop taking them, it can cause a flare-up.
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If the risk-benefit analysis for a patient with such risk factors favors the use of methotrexate, then this patient should have a liver biopsy performed at or near the beginning of methotrexate therapy.
Bulatoviç M, Heijstek MW, Verkaaik M, van Dijkhuizen EHP, Armbrust W, Hoppenreijs EPA: High prevalence of methotrexate intolerance in juvenile idiopathic arthritis: Development and validation of a methotrexate intolerance severity score.
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