RESEARCH - Longterm observational study of MTX use in patients with RA

September 7, 2005

Journal of Rheumatology

November 2003

Longterm Observational Study of Methotrexate Use in a Dutch Cohort of 1022

Patients with Rheumatoid Arthritis

MONIQUE HOEKSTRA, MART A.F.J. van de LAAR, HEIN J. BERNELOT MOENS, MARIJN

W.M. KRUIJSEN, and CEES J. HAAGSMA

ABSTRACT.

Objective. To study which factors are associated with longterm methotrexate

(MTX) use in rheumatoid arthritis (RA).

Methods. All patients with RA who had started MTX after January 1, 1993,

were selected from a regional hospital based registration system. Data on

demographic and clinical features were retrieved through chart review. By

means of life table analysis and regression analysis, MTX survival and

the relation between demographic variables, clinical features, and MTX

survival were studied.

Results. A total of 1072 MTX treatment episodes in 1022 patients were

analyzed. The cumulative MTX survival probability after 5 years was 64%, and

after 9 years was 50%. Univariate analysis showed a significant relation

between MTX survival probability and folic acid supplementation, attending

rheumatologist, concurrent prednisolone use, concurrent sulfasalazine use,

and the number of previous disease modifying drugs. In the multivariate

analysis folic acid supplementation, attending rheumatologist, and

concurrent prednisolone use remained significantly related to MTX survival.

Age, disease duration, and creatinine clearance were not.

Conclusion. In this retrospective study of 1022 patients with RA the

cumulative MTX survival probability was 64% after 5 years and 50% after 9

years. Folic acid supplementation and to a lesser extent prednisolone were

associated with a longer MTX survival. In addition, treatment strategies of

individual rheumatologists influenced MTX survival. (J Rheumatol

2003;30:2325-9)

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Mayo Clinic in Rochester

s Hopkins Medicine

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