The investigation and analysis of the adverse effects of methotrexate in the treatment of rheumatoid arthritis / 中华风湿病学杂志

ABSTRACT

Objective To investigate and analyze the adverse effect(AE) of methotrexate(MTX)in rheumatoid arthritis(RA).MethodsThree hundred and twenty-five RA patients were investigated with a questionnaire in clinical service of department of Rheumatology and Immunology, Peking University People's Hospital. SPSS 11.5 software was used for statistical analysis. Results① The total prevalence of AE was 34.2％. Among these, gastrointestinal AE were the most common, others included elevated liver enzymes,leucocytopenia,alopecia and dental ulcer. The incidence of drug withdrawal of MTX was 13.2％, elevated liver enzymes was the most common reason of withdrawal, other reasons were gastrointestinal AE, leucocytopenia,dental ulcer and alopecia. The gastrointestinal AE and dental ulcer occurred within one week after initiating the medication in average, while elevated liver enzymes and leucocytopenia usually occurred at about 1～2 months after the medication. ②The incidence of AE increased with the dosage. ③ Folic acid could significantly decrease the total incidence of AE(P＜0.05). The incidence of gastrointestinal AE, elevated liver enzymes,leucocytopenia and dental ulcer couldbe reduced by folic acid supplementation(P＜0.05).Conclusion The AE of MTX in RA treatment are common, many of which are slight and could be improved by reducing the dosage or symptomatic treatment. The AEs of MTX can be improved by folic acid supplement treatment.