ReviewImmunologic research2014
Three decades of low-dose methotrexate in rheumatoid arthritis: can we predict toxicity?
Review in Immunologic research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Methotrexate Cutaneous Ulceration: A Systematic Review of Cases.American journal of clinical dermatology · 2022Pooled it
- Polymorphisms and Pharmacogenomics for the Clinical Efficacy of Methotrexate in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-analysis.Scientific reports · 2017Pooled it
- Identification of differential co-expressed gene networks in early rheumatoid arthritis achieving sustained drug-free remission after treatment with a tocilizumab-based or methotrexate-based strategy.Arthritis research & therapy · 2017Trial
- Methotrexate versus cyclophosphamide for remission maintenance in ANCA-associated vasculitis: A randomised trial.PloS one · 2017Trial
- Article
- Carnitine deficiency augments methotrexate-mediated acute renal injury in rats.Journal of the Egyptian National Cancer Institute · 2025Article
- NF-κB Signaling Pathway in Rheumatoid Arthritis: Mechanisms and Therapeutic Potential.Molecular neurobiology · 2025Review
- Dose-intensive therapy (DIT) for infantile Pompe disease: A pilot study.Molecular genetics and metabolism reports · 2025Article
- Severe hematologic toxicity after low-dose methotrexate in ectopic pregnancy: role of MTHFR polymorphism and drug interaction - a case report and literature review.Frontiers in pharmacology · 2025Article
- A rare case of low-dose methotrexate toxicity leading to skin and mucosal toxicity and invasive pulmonary mucormycosis: a case report.Frontiers in pharmacology · 2025Article
- Harnessing the Human Microbiome for Innovative Drug Delivery Systems: Exploring Pharmacomicrobiomics and Targeted Therapies.Current pharmaceutical design · 2025Review
- Modified citrus pectin ameliorates methotrexate-induced hepatic and pulmonary toxicity: role of Nrf2, galectin-3/TLR-4/NF-κB/TNF-α and TGF-β signaling pathways.Frontiers in pharmacology · 2025Article
- Therapeutic Drug Monitoring of Low Methotrexate Doses for Drug Exposure and Adherence Assessment-Pre-Analytical Variables, Bioanalytical Issues, and Current Clinical Applications.International journal of molecular sciences · 2024Review
- Role of Vitamin C on methotrexate-induced nephrotoxicity in psoriasis context: A preclinical assessment.Toxicology reports · 2024Article
- Levamisole Ameliorates Rheumatoid Arthritis by Downregulating the PI3K/Akt Pathway in SD Rats.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Molecular mechanisms underlying methotrexate-induced intestinal injury and protective strategies.Naunyn-Schmiedeberg's archives of pharmacology · 2024Review
- The impact of the human gut microbiome on the treatment of autoimmune disease.Immunological reviews · 2024Review
- Oral Methotrexate Treatment of Delayed-Onset Inflammatory Reactions to Dermal Fillers.Aesthetic surgery journal. Open forum · 2024Article
- Drug-microbiota interactions: an emerging priority for precision medicine.Signal transduction and targeted therapy · 2023Review
- Electroacupuncture Alleviates Pain Responses and Inflammation in Collagen-Induced Arthritis Rats via Suppressing the TLR2/4-MyD88-NF-Evidence-based complementary and alternative medicine : eCAM · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Methotrexate (MTX) is the anchor disease-modifying antirheumatic drug (DMARD) in rheumatoid arthritis (RA) treatment. It is used in monotherapy and/or in combination with other synthetic or biological DMARDs, and is known to have the best cost-effectiveness and efficacy/toxicity ratios. However, toxicity is still a concern, with a significant proportion of patients interrupting long-term treatment due to the occurrence of MTX-related adverse drug reactions (ADRs), which are the main cause of drug withdrawal. Despite the extensive accumulated experience in the last three decades, it is still impossible in routine clinical practice to identify patients prone to develop MTX toxicity. While clinical and biological variables, including folate supplementation, partially help to minimize MTX-related ADRs, the advent of pharmacogenomics could provide further insight into risk stratification and help to optimize drug monitoring and long-term retention. In this paper, we aimed to review and summarize current data on low-dose MTX-associated toxicity, its prevention and predictors, keeping in mind practical RA clinical care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.