Methotrexate monitoring guidelines need updating

Current methotrexate (MTX) monitoring guidelines are too rigid and need updating, say a group of Australian rheumatologists. Despite adverse reactions with MTX being lower than initially feared, the monitoring guidelines established more than 10 years ago have not been re-evaluated, the researchers wrote in the Internal Medicine Journal. The authors said that of 790 patients seen in their private practice over an 18 year period, MTX was terminated in just 272 patients (34%). Of these patients, 93 (12%) discontinued therapy as a result of adverse reactions and 179 (23%) stopped for a variety of other reasons. Women remained on treatment significantly longer than men (HR 0.73, P = 0.014) and patients with RA remained on treatment significantly longer than patients with seronegative arthritis (HR 0.56, P < 0.001)....