Low Dose Methotrexate Safe For Rheumatoid Arthritis In Elderly
12/07/2000 07:59:31 AM
By David Loshak

Low doses of the steroid-sparing folic acid antagonist methotrexate appear
safe for treating elderly patients who have rheumatoid arthritis.

Routine determination of serum liver enzymes and renal function might reduce
individual patients' risk of side effects, Israeli researchers report.

They say that although weekly low dose methotrexate is an established
treatment for rheumatoid arthritis, its use in elderly people has not
previously been examined adequately.

The present study consisted of a retrospective review of the clinical
records of 32 women and one man (mean age 78.8 years) with rheumatoid
arthritis who were attending a rheumatology unit.

These patients were treated with methotrexate 7.5 mg/week while being
maintained on concurrent treatment and were followed for at least two years.

In four cases, treatment was discontinued, in two because of raised serum
liver enzymes and in two due to gastrointestinal irritation. No serious
adverse events were reported.

After two years, haemoglobin levels increased from a mean 12.4 g/dL to 13.0
g/dL. The white blood cell count was significantly reduced from a mean 7.9 x
109/L to 6.8 x 109/L.

The investigators observed no episodes of neutropaenia or agranulocytosis.
There was a non-significant decrease in platelet count. The erythrocyte
sedimentation rate fell from a mean 56.8 mm/h to 35.2 mm/h.


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