A 36 month comparative trial of methotrexate and gold sodium thiomalate in the treatment of early active and erosive rheumatoid arthritis

Menninger, H.; Herborn, G.; Sander, Oliver; Blechschmidt, Jutta; R, Rau

doi:10.1093/rheumatology/37.10.1060

Cited by 44 publications

(17 citation statements)

References 5 publications

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“…Adverse effects were noted in 89 % of the patients; 53 % of the patients withdrew from the study due to side effects after a mean time of 6.1 months. Of the remaining patients, clinical remission was evident in 38 % and marked improvement (more than 50 % reduction in number of swollen or tender joints) in 87 % [81].…”

Section: Case Historiesmentioning

confidence: 95%

“…Authors concluded that early symptomatic improvement of RA during gold treatment remained stable for several years, although joint relief seemed to continue over the entire treatment period [80]. Intramuscular injections of sodium gold thiomalate were used to treat 87 patients with active early erosive RA over a three-year period at 50 mg weekly the first year and 25 mg weekly thereafter [81]. Adverse effects were noted in 89 % of the patients; 53 % of the patients withdrew from the study due to side effects after a mean time of 6.1 months.…”

Section: Case Historiesmentioning

confidence: 99%

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Chrysotherapy: a synoptic review

Eisler

2003

Inflamm. res.

108

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Chrysotherapy - the treatment of rheumatoid arthritis (RA) patients with monovalent gold drugs possessing anti-inflammatory and other properties - has been used with some success for more than 70 years; however, the metabolites generated from gold drugs have not been identified positively and the mechanisms of action are not known with certainty. This account selectively reviews recent available literature on the history of gold in medicine, with emphasis on RA; the role of Au(+) and Au(+) metabolites (Au(CN)(2)(-), Au(+3), Au(o)) and other mechanisms in chrysotherapy; current treatment regimes for RA using gold drugs; chrysotherapy case histories based on 2166 RA patients; and adverse effects of chrysotherapy, mainly various forms of dermatitis. More research seems needed on the role of gold metabolites in the treatment of RA, the use of more sensitive and uniform indicators of treatment success, improved routes of drug administration for maximum efficacy, and the development of gold drugs with minimal side effects.

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Section: Case Historiesmentioning

confidence: 95%

Section: Case Historiesmentioning

confidence: 99%

Chrysotherapy: a synoptic review

Eisler

2003

Inflamm. res.

108

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“…These RCTs were followed by observational studies clearly establishing that methotrexate is effective over long periods, and that it has a better toxicity profile than other DMARDs. [112][113][114][115] Importantly , methotrexate is one of the first conventional DMARDs with proven efficacy on radiographic progression in rheumatoid arthritis. 4 In early rheumatoid arthritis, two RCTs (of 12 and 18 months' duration) failed to demonstrate the superiority of methotrexate over other DMARDs such as sulfasalazine.…”

Section: Recommendationmentioning

confidence: 99%

EULAR recommendations for the management of early arthritis: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)

Combe

Landewé

Lukas

et al. 2006

Annals of the Rheumatic Diseases

688

476

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Objective: To formulate EULAR recommendations for the management of early arthritis. Methods: In accordance with EULAR's ''standardised operating procedures'', the task force pursued an evidence based approach and an approach based on expert opinion. A steering group comprised of 14 rheumatologists representing 10 European countries. The group defined the focus of the process, the target population, and formulated an operational definition of ''management''. Each participant was invited to propose issues of interest regarding the management of early arthritis or early rheumatoid arthritis. Fifteen issues for further research were selected by use of a modified Delphi technique. A systematic literature search was carried out. Evidence was categorised according to usual guidelines. A set of draft recommendations was proposed on the basis of the research questions and the results of the literature search.. The strength of the recommendations was based on the category of evidence and expert opinion. Results: 15 research questions, covering the entire spectrum of ''management of early arthritis'', were formulated for further research; and 284 studies were identified and evaluated. Twelve recommendations for the management of early arthritis were selected and presented with short sentences. The selected statements included recognition of arthritis, referral, diagnosis, prognosis, classification, and treatment of early arthritis (information, education, non-pharmacological interventions, pharmacological treatments, and monitoring of the disease process). On the basis of expert opinion, 11 items were identified as being important for future research. Conclusions: 12 key recommendations for the management of early arthritis or early rheumatoid arthritis were developed, based on evidence in the literature and expert consensus.

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“…It is highly effective, and the American College of Rheumatology defi nition of a 20% improvement (ACR20) achievement is approximately 60% [1][2][3][4] in preventing bone erosion and improving mortality and daily activity. 5,6 However, adverse reactions to MTX have limited its usage.…”

Section: Introductionmentioning

confidence: 99%

Higher maximal serum concentration of methotrexate predicts the incidence of adverse reactions in Japanese rheumatoid arthritis patients

et al. 2007

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Weekly pulsed low-dose methotrexate (MTX) is a standard regimen for rheumatoid arthritis (RA). Severe adverse reactions to MTX, such as pneumonia and cytopenia, sometimes occur; however, it is difficult to predict the development of these adverse reactions. In this article, we examine the serum concentrations of orally administered MTX of 69 Japanese patients with RA in the clinical setting. The maximum serum concentration (C (max)) after the first dose of the weekly administration and the time at which C (max) was obtained (T (max)) were analyzed. C (max) correlated with the administered dose before measurement. The average T (max) was 2.0 +/- 0.8 h, and none of the patients showed a T (max) of more than 4 h. In addition, we demonstrated that the weekly MTX dosage and the mean dosage of steroids were significantly higher in patients with adverse reactions than in those without them, and the C (max) after the first dose of the weekly administration particularly correlated with the incidence of adverse reactions (P < 0.001). In fact, the cut-off point of C (max) (0.16 micromol/l) was a sensitive predictor of the adverse reactions (sensitivity 81% and specificity 67%). We concluded that C (max) after the first dose of weekly administration is a useful parameter for predicting the development of adverse reactions to MTX.

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A 36 month comparative trial of methotrexate and gold sodium thiomalate in the treatment of early active and erosive rheumatoid arthritis

Cited by 44 publications

References 5 publications

Chrysotherapy: a synoptic review

Chrysotherapy: a synoptic review

EULAR recommendations for the management of early arthritis: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)

Higher maximal serum concentration of methotrexate predicts the incidence of adverse reactions in Japanese rheumatoid arthritis patients

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