Article
Pharmacology & Pharmacy
Ana Socorro Rodriguez-Baez, Ana Patricia Huerta-Garcia, Susanna Edith Medellin-Garibay, Cristian Jazmin Rodriguez-Pinal, Marco Ulises Martinez-Martinez, David Herrera-Van Oostdam, Carlos Abud-Mendoza, Silvia Romano-Moreno, Rosa del Carmen Milan-Segovia
Summary: The safety and efficacy of low-dose methotrexate administered daily or weekly in rheumatoid arthritis patients were investigated in this study. The results showed a good response to methotrexate treatment in both daily and weekly dosage regimens, with similar adherence patterns. Additionally, methotrexate polyglutamate 3 concentrations could serve as a useful tool for therapeutic drug monitoring.
BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY
(2022)
Article
Rheumatology
Carlo Scognamiglio Renner Araujo, Ana Cristina Medeiros-Ribeiro, Carla G. S. Saad, Karina Rossi Bonfiglioli, Diogo Souza Domiciano, Andrea Yukie Shimabuco, Matheus Santos Rodrigues Silva, Emily Figueiredo Neves Yuki, Sandra Gofinet Pasoto, Tatiana Pedrosa, Leonard de Vinci Kanda Kupa, Gioanna Zou, Rosa M. R. Pereira, Clovis Artur Silva, Nadia Emi Aikawa, Eloisa Bonfa
Summary: This study evaluated the effect of discontinuing methotrexate (MTX) for 2 weeks after each dose of the Sinovac-CoronaVac vaccine on immunogenicity and safety in patients with rheumatoid arthritis (RA). The results showed that the group that discontinued MTX had a higher rate of seroconversion and higher antibody titers compared to the group that continued MTX. However, there was an increased risk of flare after the second MTX withdrawal.
ANNALS OF THE RHEUMATIC DISEASES
(2022)
Article
Rheumatology
Lee Jin Lim, Ashley J. W. Lim, Brandon N. S. Ooi, Justina Wei Lynn Tan, Ee Tzun Koh, Ttsh Rheumatoid Arthritis Study Group, Samuel S. Chong, Chiea Chuen Khor, Lisa Tucker-Kellogg, Caroline G. Lee, Khai Pang Leong
Summary: This study identified sensitive and specific predictors of MTX response in RA patients through a novel strategy combining biologically meaningful genetic feature selection and machine learning. These predictors may facilitate better treatment decision-making in RA management.
Article
Rheumatology
Renske C. F. Hebing, Marry Lin, Maja Bulatovic Calasan, Ittai B. Muller, Sohaila Mahmoud, Sandra Heil, Eduard A. Struys, Bart J. F. van den Bemt, Jos W. R. Twisk, Willem Lems, Michael T. Nurmohamed, Gerrit Jansen, Robert de Jonge
Summary: This study investigates the pharmacokinetics of methotrexate polyglutamate (MTX-PG) accumulation in red blood cells (RBCs) and peripheral blood mononuclear cells (PBMCs) in patients with early rheumatoid arthritis (RA) after oral and subcutaneous MTX treatment. The results show that there are disparate pharmacokinetic profiles between PBMCs and RBCs, with higher accumulation of MTX-PG in PBMCs. The distribution profile of MTX-PG in PBMCs remains constant over 6 months, while in RBCs, the main PG-moiety changes from MTX-PG(1) to MTX-PG(3).
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Article
Rheumatology
Katriona Goldmann, Athina Spiliopoulou, Andrii Iakovliev, Darren Plant, Nisha Nair, Cankut Cubuk, Paul McKeigue, Michael R. Barnes, Anne Barton, Costantino Pitzalis, Myles J. Lewis
Summary: This study conducted expression quantitative trait locus (eQTL) analysis using RNA-Sequencing to explore the link between genetic variants and gene expression in rheumatoid arthritis (RA) patients. The analysis identified 898 eQTL genes in synovium and blood, with 232 genes in common. A specific eQTL at HLA-DPB2 was found to be associated with clinical severity and the lympho-myeloid pathotype.
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Article
Rheumatology
Siddharth Jain, Varun Dhir, Amita Aggarwal, Ranjan Gupta, Bidyalaxmi Leishangthem, Shankar Naidu, Aastha Khullar, Supriya Maurya, Veena Dhawan, Shefali Khanna Sharma, Aman Sharma, Sanjay Jain
Summary: This study compared the efficacy and safety of different dose escalation strategies of oral MTX in RA patients over a period of 16-24 weeks. The results showed that a faster escalation strategy was not more effective than the usual strategy, but was associated with higher gastrointestinal adverse events in the initial phase.
ANNALS OF THE RHEUMATIC DISEASES
(2021)
Review
Pharmacology & Pharmacy
Gurleen Kour, Syed Assim Haq, Bijender Kumar Bajaj, Prem N. Gupta, Zabeer Ahmed
Summary: Phytochemicals have long been known for their therapeutic potential in autoimmune disorders such as rheumatoid arthritis, but their combination with DMARDs can increase the efficacy of treatment while reducing toxic side effects. Studies have shown promising results in experimental and clinical settings when combining phytochemicals with DMARDs, highlighting the importance of this approach in future RA therapy.
PHARMACOLOGICAL RESEARCH
(2021)
Article
Rheumatology
Paul Studenic, Daniel Aletaha, Maarten de Wit, Tanja A. Stamm, Farideh Alasti, Diane Lacaille, Josef S. Smolen, David T. Felson
Summary: This study aimed to externally validate a revised Boolean remission criteria using a higher patient global assessment (PtGA) threshold and validate the provisionally endorsed index-based criteria. The results showed that using the higher PtGA threshold increased the proportion of patients classified as achieving remission under the "Boolean2.0" criteria, improved agreement with index-based criteria, and did not compromise predictive value for radiographic or functional outcomes. The study findings were endorsed by ACR and EULAR.
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Article
Rheumatology
Mikkel Ostergaard, Ronald F. van Vollenhoven, Anna Rudin, Merete Lund Hetland, Marte Schrumpf Heiberg, Dan C. Nordstrom, Michael T. Nurmohamed, Bjorn Gudbjornsson, Lykke Midtboll Ornbjerg, Pernille Boyesen, Kristina Lend, Kim Horslev-Petersen, Till Uhlig, Tuulikki Sokka, Gerdur Grondal, Simon Krabbe, Joakim Lindqvist, Inger Gjertsson, Daniel Glinatsi, Meliha Crnkic Kapetanovic, Anna-Birgitte Aga, Francesca Faustini, Pinja Parmanne, Tove Lorenzen, Cagnotto Giovanni, Johan Back, Oliver Hendricks, Daisy Vedder, Tuomas Rannio, Emma Grenholm, Maud Kristine Ljosa, Eli Brodin, Hanne Lindegaard, Annika Soderbergh, Milad Rizk, Alf Kastbom, Per Larsson, Line Uhrenholt, Soren Andreas Just, David J. Stevens, Trine Bay Laurbjerg, Gunnstein Bakland, Inge Christoffer Olsen, Espen A. Haavardsholm, Jon Lampa, NORD-STAR Study Grp
Summary: This study compared the clinical and radiographic outcomes of different biological treatments with active conventional therapy in patients with early rheumatoid arthritis (RA). The results showed that abatacept and certolizumab pegol had higher clinical remission rates compared to active conventional therapy, while tocilizumab did not show significant differences. Radiographic progression was low and similar across treatments.
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Article
Rheumatology
Chang Xu, Jacob Selhub, Paul Jacques, Nina P. Paynter, Jean G. MacFadyen, Robert J. Glynn, Paul M. Ridker, Daniel H. Solomon
Summary: This study found that the concentrations of MTX-PGs 3-5 were moderately associated with adverse effects of low-dose methotrexate, including anemia and liver function abnormalities. However, higher levels of MTX-PGs 3-5 were also associated with a reduced risk of thrombocytopenia and hemorrhage.
Article
Medicine, General & Internal
Ashley J. W. Lim, Lee Jin Lim, Brandon N. S. Ooi, Ee Tzun Koh, Justina Wei Lynn Tan, Samuel S. Chong, Chiea Chuen Khor, Lisa Tucker-Kellogg, Khai Pang Leong, Caroline G. Lee
Summary: This study proposes a novel approach to predict methotrexate response in rheumatoid arthritis patients by integrating coding haplotypes and machine learning. Through machine learning models, 100 features with good predictive performance were identified, with the majority of predictive pfcHap SNPs predicted to be potentially functional.
Article
Rheumatology
Eva Vermeer, Renske C. F. Hebing, Maartje M. van de Meeberg, Marry Lin, Tim G. J. de Meij, Eduard A. Struys, Gerrit Jansen, Michael T. Nurmohamed, Maja Bulatovic Calasan, Robert de Jonge
Summary: There is no conclusive evidence supporting the superiority of either oral or subcutaneous administration of methotrexate (MTX) in immune-mediated inflammatory disorders (IMIDs). Subcutaneous administration leads to higher plasma bioavailability and initial accumulation of MTX-polyglutamates (MTX-PGs) in red blood cells (RBCs), but the difference seems to disappear over time. The choice of administration route may be based on shared decision-making, offering patients the option of either oral or subcutaneous administration of MTX based on individual preferences and tolerability.
CURRENT RHEUMATOLOGY REPORTS
(2023)
Article
Rheumatology
Andreas Kerschbaumer, Zaida Iasha Rivai, Josef S. Smolen, Daniel Aletaha
Summary: This study analyzed the response differences in patients with rheumatoid arthritis receiving placebo treatment, comparing those who continued background therapy with methotrexate (MTX) and those without any disease modifying antirheumatic drugs (DMARDs). The results showed that placebo responses were higher in patients who continued MTX background therapy, suggesting a more consequent intake of background therapy during the trial period.
ANNALS OF THE RHEUMATIC DISEASES
(2022)
Article
Medicine, General & Internal
Edyta Majorczyk, Malgorzata Mazurek-Mochol, Andrzej Pawlik, Piotr Kusnierczyk
Summary: In this study, we examined 312 patients with rheumatoid arthritis and found that older age at disease onset, low ESR, no erosive disease, and negative RF were independent factors associated with a good response to methotrexate treatment. However, younger age at disease onset, the presence of RF, erosive disease, and a high level of ESR were associated with a worse response to methotrexate therapy.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Rheumatology
Delila Singh, Nina Hesse, Alla Skapenko, Hendrik Schulze-Koops
Summary: Methotrexate is associated with rare bone lesions that are often misdiagnosed as osteoporotic fractures. Early diagnosis is crucial for treatment and prevention of further osteopathology. This case highlights the importance of raising awareness and taking appropriate therapeutic measures, including discontinuing methotrexate.