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Carol Eustice

Long-term Methotrexate Use Appears Safe for Rheumatoid Arthritis Patients

By July 11, 2009

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Potential side effects of methotrexate can worry rheumatoid arthritis patients. But there may be good news -- long-term treatment with the drug appears safe, according to study results published in the July 2009 issue of the Annals of the Rheumatic Diseases. That conclusion is based on pooled data from 88 studies that involved patients treated with methotrexate for at least 2 years.

Many patients taking methotrexate experience side effects but usually they are mild. Discontinuation rates of methotrexate were less than sulfasalazine, gold, and penicillamine -- but more than plaquenil. While 13% of patients experienced elevated liver enzymes -- only 3.7% had to stop using methotrexate due to liver toxicity.

Methotrexate was not tied to an increased risk of infections. Two of the studies assessed the relationship of methotrexate to cardiovascular disease while being treated. One concluded there was no increased risk of cardiovascular disease -- while the other suggested there may even be a reduced cardiovascular risk while taking methotrexate.

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