Methotrexate in chronic-recurrent calcium pyrophosphate deposition disease: no significant effect in a randomized crossover trial
Autor: | Pierre-André Guerne, Sandra Blumhardt, Axel Finckh, Marcel Weber, Diego Kyburz, Georges Rappoport, Daniel Van Linthoudt, David Neto, Geraldine M Mc Carthy, Anne Madigan |
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Rok vydání: | 2014 |
Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Immunology Arthritis Chondrocalcinosis Placebo Gastroenterology law.invention chemistry.chemical_compound Double-Blind Method Rheumatology Randomized controlled trial Recurrence law Internal medicine Arthropathy medicine Humans Immunology and Allergy Aged ddc:616 Aged 80 and over Cross-Over Studies business.industry Calcium pyrophosphate Middle Aged medicine.disease Crossover study Surgery Methotrexate Treatment Outcome chemistry Antirheumatic Agents Chronic Disease Female Polyarthritis business Research Article |
Zdroj: | Arthritis Research & Therapy Arthritis Research and Therapy, Vol. 16, No 5 (2014) P. 458 |
ISSN: | 1478-6354 |
Popis: | Introduction Calcium pyrophosphate deposition (CPPD) may cause severe arthropathy, major joint destruction and treatment options are limited. The aim of this study was to test the therapeutic efficacy of methotrexate (MTX) in chronic or recurrent CPPD arthropathy. Methods Patients with CPPD arthropathy were randomized to receive either weekly subcutaneous injections of 15 mg/week of MTX or placebo (PBO) for three months, in a double-blind, crossover randomized controlled trial. Inclusion criteria comprised definite CPPD disease, recurrent arthritis or persistent polyarthritis, and an insufficient response to NSAIDs, glucocorticoids or colchicine. The primary outcome was an improvement in the disease activity scores based on 44 joints (DAS44). The analysis was performed on an intent-to-treat basis. Results We randomized 26 patients, and compared 25 treatment periods on MTX with 21 treatment periods on PBO. Baseline characteristics were balanced between the groups. The evolution of the DAS44 was not statistically significantly different between groups (median DAS44 decreased by −0.08 on MTX versus −0.13 on PBO, after three months, P = 0.44). Furthermore, pain levels remained stable in both groups (median change in VAS Pain −1 unit on MTX and 0 on PBO, P = 0.43), and none of the secondary outcomes was significantly different between the two groups. Minor adverse events (AE) did not differ in frequency between the groups, but the only serious AE occurred on MTX (bicytopenia). Conclusions The results of this trial with MTX in this older population with chronic or recurrent CPPD arthropathy suggest no strong effect of MTX on disease activity. Trial registration EudraCT No: 2007-003479-37. Registered 26 April 2008 |
Databáze: | OpenAIRE |
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