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Methotrexate in Rheumatoid Arthritis

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▸Requests for information and reprints should be addressed to Linda Johnson White, Director, Department of Scientific Policy, American College of Physicians, 4200 Pine Street, Philadelphia, PA 19104.

© 1987 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1987;107(3):418-419. doi:10.7326/0003-4819-107-2-418
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Methotrexate, a folic-acid antagonist and well-known anticancer drug, was first used to treat rheumatoid arthritis in the early 1950s [2.2] Because of growing interest in the use of immunosuppressive drugs in the treatment of rheumatoid arthritis, methotrexate received increasing attention in the late 1970s and early 1980s as a third-line agent [2.1, 2.3] for use in patients with disease refractory to first-line (nonsteroidal anti-inflammatory agents) and second-line agents (antimalarials, gold salts, or D-penicillamine).

Four placebo-controlled clinical trials [2.2, 3.11] have been published documenting the short-term clinical benefit of methotrexate. However, the benefits of long-term treatment are still unclear [3.22], and


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