Intra-articular methotrexate. Clinical and laboratory study in rheumatoid and psoriatic arthritis.

Hall, G. H.; Jones, B J; Head, A; Jones, Valerie E.

doi:10.1136/ard.37.4.351

Cited by 39 publications

(12 citation statements)

References 13 publications

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“…Methotrexate (MTX) readily blocks the proliferation of a wide variety of human tissues. Nevertheless, when injected intraarticularly in small single doses of 2.5-5 mg, MTX does not adequately control the synovitis of RA (1)(2)(3). This lack of clinical efficacy may be due to the cell cycle phase specific action of MTX whose toxicity is limited to cells in S-phase (4).…”

mentioning

confidence: 99%

Methotrexate pharmacokinetics after intraarticular injection in patients with rheumatoid arthritis

Wigginton

Chu

Weisman

et al. 1980

Arthritis & Rheumatism

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mentioning

confidence: 99%

Methotrexate pharmacokinetics after intraarticular injection in patients with rheumatoid arthritis

Wigginton

Chu

Weisman

et al. 1980

Arthritis & Rheumatism

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“…The effects of intra-articular MTX have been previously evaluated with controversy and inconstantly favourable results [16][17][18][32][33][34][35][36][37]. As far as we know, this is the first study that investigates the effects of intraarticular MTX in RA and PsA both clinically and by ultrasound.…”

Section: Resultsmentioning

confidence: 99%

“…Intra-articular administration has been reported, with possibly favourable results [13][14][15] and rare negative side effects [16]. The local use of the compound is supported by the aim of achieving maximal anti-inflammatory and immunosuppressive effects on the synovial membrane [17,18].…”

Section: Introdu~kionmentioning

confidence: 99%

Intra-articular methotrexate in the treatment of rheumatoid arthritis and psoriatic arthritis: a clinical and sonographic study

et al. 2006

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The aim of our study was to evaluate the effects of intra-articular methotrexate (MTX) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Twenty-three consecutive patients, 10 with RA and 13 with PsA, with prevalent or unique arthritic involvement of one knee, were treated with intra-articular injections of MTX 10 mg every 7 days for 8 weeks. Before the beginning of the treatment and after 9 and 17 weeks, the patients underwent a clinical evaluation measuring maximal knee flexion angle, visual analog scale (VAS) and erythrocyte sedimentation rate (ESR). On the same days, an ultrasonographic examination of the involved knee was performed by two independent experienced operators. Synovial thickness in the suprapatellar bursa and the presence of joint effusion and Baker's cyst were assessed. An increase of the mean value of maximal knee flexion angle and a reduction of the mean values of ESR and VAS between TO, T9 and T17 were demonstrated. Ultrasonographic evaluation showed significant reduction of synovial thickness and joint effusion. No differences were detected for the presence of Baker's cyst. We may conclude that repeated intra-articular injections of MTX resulted in a decrease of local as well as systemic inflammatory signs. As far as we know, this is the first study that explores the effects of intra-articular MTX in RA and PsA both clinically and by ultrasonography.

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“…The dosage was determined using a previous report that the minimum and maximum effective dosages were 2.5 and 10.0 mg, respectively. 12…”

Section: Methodsmentioning

confidence: 99%

Safety of Intra-articular Methotrexate Injection With and Without Electroporation for Inflammatory Small Joints in Patients With Rheumatoid Arthritis

Tada

Inui

Okano

et al. 2019

Clin Med�Insights�Arthritis�Musculoskelet Disord

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The general disease activity of patients with rheumatoid arthritis (RA) is well controlled by disease-modifying antirheumatic drugs, but local inflammation often remains in a few small joints. Electroporation, making small pores in cell membranes, has proven useful for drug delivery. The safety of a combination therapy of methotrexate (MTX) and electroporation for local joint inflammation in RA was investigated in a prospective, randomized, double-blind, placebo-controlled, exploratory study (UMIN000016606). The patients were randomly allocated to groups receiving a combination of MTX and electroporation (True-EP) and MTX alone (False-EP) groups. The MTX solution was injected into finger joints under ultrasound guidance. The True-EP group underwent electroporation with MTX, and the False-EP group was given MTX but only pinched using the electrode. The ultrasound grade, disease activity, and safety were evaluated from baseline to 26 weeks. Five patients (3 True-EP and 2 False-EP) with a mean age of 57.4 years and disease duration of 10.2 years were enrolled. The grey-scale grade was unchanged in 3 cases (2 True-EP and 1 False-EP) and increased in 2 cases (1 True-EP and 1 False-EP). Disease activity was alleviated in 3 cases (2 True-EP and 1 False-EP). No patients experienced burned skin or electroshock. The combination therapy of electroporation and MTX was safe for RA patients.

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Intra-articular methotrexate. Clinical and laboratory study in rheumatoid and psoriatic arthritis.

Cited by 39 publications

References 13 publications

Methotrexate pharmacokinetics after intraarticular injection in patients with rheumatoid arthritis

Methotrexate pharmacokinetics after intraarticular injection in patients with rheumatoid arthritis

Intra-articular methotrexate in the treatment of rheumatoid arthritis and psoriatic arthritis: a clinical and sonographic study

Safety of Intra-articular Methotrexate Injection With and Without Electroporation for Inflammatory Small Joints in Patients With Rheumatoid Arthritis

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