A recent study by Kumar et al, published in Current Orthopaedic Practice found
methotrexate (MTX) as a safe and effective choice of treatment among rheumatoid
arthritis (RA) patients.
Various therapeutic modalities are used for controlling the
RA disease activity, but each of them suffers from various advantages and
limitations. This study aimed to analyze the effectiveness and toxicity of MTX
on liver and lipid functions in selected RA patients and controls.
The study included patients with RA who receiving MTX
therapy who underwent a long-term follow-up. Various parameters like analysis
of lipid parameters, inflammatory markers as erythrocyte sedimentation rate
(ESR) and C-reactive protein (CRP), essential mineral accumulation, and liver
and kidney function test were analyzed in the control and patient groups.
The study results showed reduced levels of hemoglobin in RA
patients, whereas ESR, CRP and pain on the visual analog scale (VAS) were
significantly higher when compared to controls.
Alanine aminotransferase, aspartate aminotransferase and uric acid
levels were found within the normal range. A significant reduction in serum
magnesium and higher values for zinc, phosphorous, and copper were also
observed in RA patients. They were found to have a borderline dyslipidemia.
Overall, the results were conclusive that MTX can be a safe
and effective for the treatment of RA. The liver function test of RA patients
was normal but patients experienced disturbances in mineral accumulation, suggesting
the need for mineral evaluation and supplementation, especially of magnesium in
RA patients. The treatment was helpful in reducing inflammation and the
activity of the disease and was effective for lipid parameters that in turn
reduce the risk of cardiovascular disease.
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