Gene-body mass index interactions are associated with methotrexate toxicity in rheumatoid arthritis: Table 1

Aslibekyan, Stella; Jiang, Sha; Redden, David T.; Moreland, Larry W.; O'Dell, James Robert; Curtis, Jeffrey R.; Mikuls, Ted R.; Reynolds, Richard J.; Danila, Maria I.; Bridges, S. Louis

doi:10.1136/annrheumdis-2013-204263

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…High BMI itself can cause elevated transaminases but normalisation of biochemistry following MTX discontinuation and absence of significant steatosis (>5% in only two patients) on histology indicates the drug to be the cause rather than obesity. This finding is similar to studies in adults implicating obesity as significant risk factor though it is difficult to draw definitive conclusions given the small size of our cohort.…”

Section: Discussionsupporting

confidence: 85%

Liver injury in children with long‐term low‐dose methotrexate

et al. 2019

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Section: Discussionsupporting

confidence: 85%

Liver injury in children with long‐term low‐dose methotrexate

et al. 2019

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“…Also for mechanisms underlying (unacceptable) side effects, no studies have been reported in D2T RA patients specifically. In studies in RA patients who failed b/tsDMARDs, mechanisms were generally found to be directly related to the mechanism of action of DMARDs and general immune mechanisms were not found ( Supplementary Table S2 , available at Rheumatology online) [ 15 , 17 , 23 , 27 , 53–55 , 59 , 67 , 71 , 80 , 81 , 93 , 96 , 97 , 100 , 102 , 113 , 116 ]. As for mechanisms underlying inefficacy, immune mechanisms underlying side effects were also found to be influenced by (epi)genetics and clinical characteristics.…”

Section: Resultsmentioning

confidence: 99%

Mechanisms underlying DMARD inefficacy in difficult-to-treat rheumatoid arthritis: a narrative review with systematic literature search

et al. 2022

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Management of rheumatoid arthritis (RA) patients has significantly improved over the past decades. However, a substantial proportion of patients is difficult-to-treat (D2T), remaining symptomatic after failing biological and/or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). Multiple factors can contribute to D2T RA, including treatment non-adherence, comorbidities and co-existing mimicking diseases (e.g. fibromyalgia). Additionally, currently available (b/ts)DMARDs may be truly ineffective (‘true’ refractory RA) and/or lead to unacceptable side effects. In this narrative review based on a systematic literature search, an overview of underlying (immune) mechanisms is presented. Potential scenarios are discussed including the influence of different levels of gene expression and clinical characteristics. Although the exact underlying mechanisms remain largely unknown, the heterogeneity between individual patients supports the assumption that (D2T) RA is a syndrome involving different pathogenic mechanisms.

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“…Treatment options for RA include nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), local steroids, and biologics. Methotrexate (MTX), one of the DMARDs, is the first-line drug for treating RA [ 5 ]. The treatment methods do not retard or stop the radiographic progression or prevent joint damage.…”

Section: Introductionmentioning

confidence: 99%

Systemic Review and Meta-Analysis of the Clinical Efficacy and Adverse Effects of Zhengqing Fengtongning Combined with Methotrexate in Rheumatoid Arthritis

Chen

Huang

et al. 2015

Evidence-Based Complementary and Alternative Medicine

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Chinese medicines are gaining wider acceptance. They have been used for treating rheumatoid arthritis (RA) for thousands of years, and the need to investigate the interaction between Chinese medicines and western medicines is widely recognized. In this study, a large number of RCTs and CCTs were analyzed to systematically assess the effects and adverse events of Zhengqing Fengtongning (ZQFTN) for RA. Eleven studies that contained 956 participants (508 in the treatment group; 448 in the control group) were included. The results showed that although ZQFTN combined with methotrexate MTX could not decrease the swollen joint count and tender joint count of RA patients better than MTX alone, the combination therapy might relieve the duration of morning stiffness (SMD: −16.06; 95% CI: −28.77 to −3.34), reduce laboratory indexes (RF: SMD: −10.84; 95% CI: −19.39 to −2.29; ESR: SMD: −7.26; 95% CI: −11.54 to −2.99; CRP: SMD: −3.66; 95% CI: −5.94 to −1.38), and improve the overall effect (RR: 1.08; CI: 1.01 to 1.16) better than monotherapy. The combination therapy was significantly better in controlling adverse drug reactions (RR: 0.60; 95% CI: 0.46 to 0.79). Through this systematic review, we found that ZQFTN combined with MTX for the treatment of RA might have better clinical efficacy than MTX only and might be superior in terms of controlling adverse drug reactions.

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Gene-body mass index interactions are associated with methotrexate toxicity in rheumatoid arthritis: Table 1

Cited by 6 publications

References 6 publications

Liver injury in children with long‐term low‐dose methotrexate

Liver injury in children with long‐term low‐dose methotrexate

Mechanisms underlying DMARD inefficacy in difficult-to-treat rheumatoid arthritis: a narrative review with systematic literature search

Systemic Review and Meta-Analysis of the Clinical Efficacy and Adverse Effects of Zhengqing Fengtongning Combined with Methotrexate in Rheumatoid Arthritis

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