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The frequency and clinical characteristics of methotrexate (MTX) oral toxicity in rheumatoid arthritis (RA): A masked and controlled study

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Summary

To assess the frequency and clinical characteristics of methotrexate (MTX) oral toxicity in rheumatoid arthritis (RA) patients, 51 RA patients receiving MTX and 46 RA patients not receiving MTX were studied. A questionnaire, the credibility of which was tested on four separate patient groups including a group with Behcet's Syndrome, was used as a tool to determine the prevalence of stomatitis by a blind observer. In this first controlled study of the oral toxicity of MTX, prevalence of stomatitis was found in 37.2% in the group taking MTX and 19.5% in the group not taking MTX (P=0.054). No statistical differences were detected with respect to number, duration, frequency, and site of stomatitis. Two of the 51 MTX taking patients temporarily reduced their MTX dosage and only one patient temporarily terminated MTX treatment. MTX and toxicity is usually of no major clinical concern in the treatment of RA.

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References

  1. Alarcon, G.S., Tracy, I.C., Blackburn, W.D. Methotrexate in limiting long-term treatment. Arthritis Rheum 1989, 32, 671–677.

    PubMed  Google Scholar 

  2. Brooks, P. Current issues of methotrexate and cyclosporine. Current Opinion in Rheumatol 1992, 4, 309–313.

    Google Scholar 

  3. Buchbinder, R., Hall, S., Sambrook, P.N., et al. Methotrexate therapy in rheumatoid arthritis: A life table review of 587 patients treated in community practice. J Rheumatol 1993, 20, 639–644.

    PubMed  Google Scholar 

  4. Felson, D.T., Anderson, J.J., Meenan, R.F. Use of short term efficacy-toxicity tradeoffs to select second-line drugs in rheumatoid arthritis. Arthritis Rheum, 1992, 35, 1117–1125.

    PubMed  Google Scholar 

  5. Hamuryudan, V. Behcet Sendromu aftlarinda lokal alfainterferon tedavisi: Plasebo kontrollu cift kor bir calisma. MD Thesis, Cerrahpasa Medical Faculty, Istanbul, 1991.

    Google Scholar 

  6. Kremer, J.M., Phelps, J.T. Long-term prospective study of the use of methotrexate in the treatment of rheumatoid arthritis. Arthritis Rheum 1992, 35, 138–145.

    PubMed  Google Scholar 

  7. Main, D.M.G., Chamberlain, M.A. Clinical differentiation of oral ulceration in Behçet's disease. Br J Rheumatol 1992, 31, 767–770.

    PubMed  Google Scholar 

  8. McKendry, R.J.R., Dale, P. Adverse effects of low dose methotrexate therapy in rheumatoid arthritis. J Rheumatol 1993, 20, 1850–1856.

    PubMed  Google Scholar 

  9. Montecucco, C., Caporali, R., Rossi, S., Porta, C. Allopurinol mouthwashes in methotrexate-induced stomatitis. Arthritis Rheum 1993, 37, 777–779.

    Google Scholar 

  10. Morand, E.F., McCloud, P.L., Littlejohn, G.O. Life table analysis of 879 treatment episodes with slow acting antirheumatic drugs in community rheumatology practice. J Rheumatol 1992, 19, 704–708.

    PubMed  Google Scholar 

  11. O'Duffy, J.D. Vasculitis in Behçet's disease. Rheumatic Dis Clin of N Am 1990, 16, 123–131.

    Google Scholar 

  12. Redding, S.W. Dental correlation: chemotherapy. In: Internal Medicine for Dentistry. Eds.: L.F. Rose and D. Kaye. The C.V. Mosby Co., St. Louis, 2nd ed., Section VI; 1990, pp. 390–393.

    Google Scholar 

  13. Rooney, T.W. Methotrexate. In: Arthritis and Allied Conditions. 12th ed. Eds.: D.J. McCarty and W.J. Koopman. Lea & Febiger Co., Philadelphia, 1993, Chapter 34, pp. 621–637.

    Google Scholar 

  14. Shiroky, J.B., Neville, C., Esdaile, J.M. et al. Low-dose methotrexate with leucovorin in the management of rheumatoid arthritis. Arthritis Rheum 1993, 36, 796–803.

    Google Scholar 

  15. Singh, G., Fries, J.F., Williams, C.A. et al. Toxicity profiles of disease modifying antirheumatic drugs in rheumatoid arthritis. J Rheumatol 1991, 18, 188–194.

    PubMed  Google Scholar 

  16. Tugwell, P., Bennett, K., Gent, M. Methotrexate in rheumatoid arthritis. Ann Intern Med 1987, 107, 358–366.

    PubMed  Google Scholar 

  17. Weinblatt, M.E., Kaplan, H., Germain, B.F. et al. Methotrexate in rheumatoid arthritis: Effects on disease activity in a multicenter prospective study. J Rheumatol 1991, 18, 334–338.

    PubMed  Google Scholar 

  18. Weinblatt, M.E., Maier, A.L., Coblyn, J. Low dose leucovorin does not interfere with the efficacy of methotrexate in rheumatoid arthritis: An eight-week randomized placebo controlled trial. J Rheumatol 1993, 20, 950–952.

    PubMed  Google Scholar 

  19. Wolfe, F., Hawley, D.J., Cathey, M.A. Termination of slow acting antirheumatic therapy in rheumatoid arthritis: A 14-year prospective evaluation of 1017 consecutive starts. J Rheumatol 1990, 17, 994–1002.

    PubMed  Google Scholar 

  20. Wolfe, F., Cathey, M.A. The effect of age on methotrexate efficacy and toxicity. J Rheumatol 1991, 18, 973–977.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. From the Department of Medicine, Department of Rheumatology, Cerrahpasa Medical Faculty, University of Istanbul, Turkey

    Y. Yazici, V. Hamuryudan & H. Yazici

  2. Saint Louis University School of Medicine (Health Science Centre), Saint Louis, MO

    Akgun Ince M.D.

  3. Dept. of Internal Medicine, Creighton University School of Medicine, Omaha, NE

    Y. Yazici, V. Hamuryudan & H. Yazici

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  1. Akgun Ince M.D.
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  2. Y. Yazici
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  3. V. Hamuryudan
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  4. H. Yazici
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Ince, A., Yazici, Y., Hamuryudan, V. et al. The frequency and clinical characteristics of methotrexate (MTX) oral toxicity in rheumatoid arthritis (RA): A masked and controlled study. Clin Rheumatol 15, 491–494 (1996). https://doi.org/10.1007/BF02229648

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  • DOI: https://doi.org/10.1007/BF02229648

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