Scroll Up
Scroll Down
Play Play Play Play
Unregistered User
Click here if this is not your Personal Edition
 
Contact Us | Free E-Mail Updates | Journals | Register a colleague
 
 
Rheumatology Other
 
   
 
SEARCH   
Doctor's Guide Free CME
Medline
Congress Resource Centre
 

 EXPLORE :
   Most Read News
 All News  All News
 All Webcasts / CME  All Webcasts / CME
 All Cases  All Cases
 Congress Resource Centre  Congress Resource Centre
 All Medical Resources  All Medical Resources
 Medical  My Personal Edition



Warning | Privacy

 

 
 Recent news - Rheumatology Other
    Adalimumab Decreases Rate of Anterior Uveitis in Ankylosing Spondylitis: Presented at AAO - (DGDispatch)
    Studies Examine Efficacy of Febuxostat in Gout, Protective Effects of Uric Acid - (DGNews)
    Adalimumab Does Not Inhibit Radiographic Progression in Ankylosing Spondylitis After 2 Years of Treatment: Presented at ACR-ARHP - (DGDispatch)
    Allopurinol Treatment May Reduce Mortality Risk in Hyperuricaemic Patients: Presented at ACR-ARHP - (DGDispatch)
    Pegloticase Shows Efficacy for Gout Symptoms: Presented at ACR-ARHP - (DGDispatch)

    News archive

     Recent webcasts/CME - Rheumatology Other
      B-Cell Biology and B-Cell-Targeted Therapies for Autoimmune Rheumatic Diseases: The Role of the Allied Health Professional
      Advances in B-Cell Biology in the Treatment of Autoimmune and Inflammatory Diseases
      Neuroinflammatory Diseases in Rheumatology
      Headache in Patients with Rheumatic Disease: When to Worry
      CNS Vasculitis

      Webcasts/CME archive

       Recent cases - Rheumatology Other
        Takayasu Arteritis in Children
        An Adolescent with Both Wegener's Granulomatosis and Chronic Blastomycosis
        Dysphagia Secondary to Dermatomyositis Treated Successfully with Intravenous Immunoglobulin: A Case Report
        F-18-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography for the Diagnosis of Takayasu's Arteritis in Stroke: A Case Report
        Sigmoid Sinus Thrombosis Presenting with Posterior Alexia in a Patient with Behcet's Disease And Polycythaemia: A Case Report

        Cases archive
          




        my personal edition > rheumatology other > news
        divider

          E-Mail this DGReview to a colleague

        DGReview


        Long-Term Methotrexate Works In Wegener's Granulomatosis Patients

        A DGReview of :"High rate of renal relapse in 71 patients with Wegener's granulomatosis under maintenance of remission with low-dose methotrexate"
        Arthritis Care and Research

        07/26/2002
        By Anne MacLennan


        Weekly methotrexate is well tolerated for long-term maintenance of remission in patients with generalised Wegener's granulomatosis.

        Nevertheless, close monitoring of these patients is critical, warns a study from Germany.

        In the study, one-third of the patients, whether or not they were still on concomitant glucocorticoids (GC), relapsed during ongoing methotrexate (MTX) treatment.

        The fact that more than half of the relapses affected the kidney underscores the need for monitoring.

        Dr. Eva Reinhold-Keller and colleagues from the Medical University of Lubeck, Lubeck, and the Medical School of Hannover, Hannover, Germany, did this open-label, prospective study to examine long-term efficacy of low-dose intravenous MTX, with and without GC, for remission of this condition.

        Participants were 71 patients (41 men and 30 women) with initially generalised Wegener's granulomatosis (WG).

        After induction of remission by cyclophosphamide and GC, patients received low-dose methotrexate at 0.3 mg/kg body weight once weekly.

        At study onset, 55 of the 71 patients (77.5 percent) were on low-dose GC (mean 5.9 mg/day), which was tapered during the study.

        The patients all underwent interdisciplinary staging, first at three-month and later at six-month intervals. This was for assessment of disease activity and extent, as well as for side effects. End points were the first relapse or the end of study (January 2001).

        In the mean 25.2-month follow-up, 26 patients (36.6 percent) relapsed after a mean of 19.4 months. Of these 26 patients, 17 (65.4 percent) had terminated GC therapy at time of relapse.

        Rates of relapse did not differ among patients with and without concomitant GC at study start. Relapses occurred mainly in the initially involved organ systems, preferentially in the ear, nose and throat tract in 18 of 26 patients and the kidney in 16 of 26 patients. One renal relapse presented as rapid, progressive glomerulonephritis with lethal outcome.

        Further, 14 relapses were accompanied by a significant rise in creatinine values. In 15 of the 26 relapsed patients, relapse was paralleled or preceded by a significant rise of antineutrophil cytoplasmic antibody titer. Two patients quit MTX prematurely because of persistent leukopenia.
        Arthritis Care & Research Volume 47, Issue 3, 2002. Pages: 326-332. "High rate of renal relapse in 71 patients with Wegener's granulomatosis under maintenance of remission with low-dose methotrexate"

        E-Mail this DGReview to a colleague   To print, use this version






        All contents Copyright (c) 1995-2008 Doctor's Guide Publishing Limited. All rights reserved.



        The NTK initiative. Physicians helping physicians identify Need-To-Know science
           Feedback
        Please rate this article: Strongly DISAGREE...Strongly AGREE NTK logo
        Question 1 - Physicians need to become aware of this information as soon as possible. Question 2 - This information is likely to have an impact on the way physicians practice medicine.
        1
        2
        3
        4
        5
        6
        7
        Send