William S. Wilke, MD; Joel M. Kremer, MD; Allen M. Mackenzie, MD; Allen M. Segal, DO; Daniel J. Mazanec, MD; Anna P. Koo, MD; Leonard H. Calabrese, DO; Raymond J. Scheetz, MD; Constance S. White, MD; John D. Clough, MD
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To the Editor: We were pleased to read the review on methotrexate treatment for rheumatoid arthritis by Tugwell and associates (1) and the position paper of the American College of Physicians (2). We agree that it is prudent to adopt a conservative position about the use of methotrexate for treating patients with rheumatoid arthritis. We feel that it is important that the drug be administered safely.
The position paper recommends that methotrexate be administered in pulse fashion once weekly but in three divided doses 12 hours apart. We disagree with this recommendation.
The divided-dose regimen for the use of methotrexate
Wilke WS, Kremer JM, Mackenzie AM, Segal AM, Mazanec DJ, Koo AP, et al. Methotrexate and Rheumatoid Arthritis. Ann Intern Med. ;110:88–90. doi: 10.7326/0003-4819-110-1-88_2
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Published: Ann Intern Med. 1989;110(1):88-90.
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