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MODERN RHEUMATOLOGY Vol.14 No.2
>MR14-2
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| Pharmacokinetics and efficacy of low-dose methotrexate in patients with rheumatoid arthritis |
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| Yoshiko Hiraga1, Yoshimitsu Yuhki1, Katsumi Itoh1, Kohji Tadano1, Yasushi Takahashi1 and Masaya Mukai2 |
(1) Department of Pharmacy, Sapporo City General Hospital, Sapporo, Japan
(2) Division of Clinical Immunology and Hematology, Department of Medicine, Sapporo City General Hospital, Kita 11-jo, Nishi 13-chome, Chuo-ku, Sapporo, 060-8604, Japan |
Received: 25 June 2003 Accepted: 09 December 2003 |
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Abstract |
| This article evaluates the relationship between the pharmacokinetics of methotrexate (MTX), its efficacy in the treatment of rheumatoid arthritis (RA), and serum folic acid (FA) levels. The pharmacokinetics of MTX was studied in 29 patients with RA treated with low-dose MTX. The weekly dose of MTX was given orally at 2?4mg every 12h over a period of 24?36h. Blood samples were taken 4h after the first administration in any given week. A Bayesian method was used to estimate individual MTX pharmacokinetic variables. We then investigated the efficacy of MTX and the serum FA levels in these patients. We examined C-reactive protein levels (CRP) and the erythrocyte sedimentation rate (ESR), and analyzed the values obtained before and after MTX treatment in order to evaluate the efficacy of the MTX treatment. The degree of improvement in CRP and ESR was significantly correlated with the length of time the MTX concentration?time curve remained above 0.02μM in one week. Furthermore, the degree of improvement in CRP was also significantly correlated with the area under the concentration?time curve (AUC) for MTX. These results suggest that serum MTX measurements could be useful in determining individual patient regimens. |
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| Key words |
| Methotrexate (MTX) - Pharmacokinetics - Rheumatoid arthritis (RA) |
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