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Low-dose methotrexate: 2-year follow-up of adverse events

FEATURED REVIEW Low-dose methotrexate is a useful first-line treatment in a range of autoimmune diseases such as rheumatoid arthritis. A 2-year follow-up of several thousand patients provides new estimates of the frequency of adverse events.
Full review (2 pages) available for download by subscribers.


  • A follow-up of approximately 2 years involving several thousand patients with coronary heart disease (most of whom had type 2 diabetes), included in a placebo-controlled clinical trial of low-dose methotrexate, provides useful data for monitoring of patients taking methotrexate long-term.

  • Compared to placebo, hepatic and gastro-intestinal disorders, and leukopenia were more frequently reported in patients on methotrexate. Hepatic disorders and skin cancer (particularly squamous cell carcinoma) were twice as frequent. There were also reports of cirrhosis.

©Prescrire 1 July 2021

Source: "Low-dose methotrexate: 2-year follow-up of adverse events" Prescrire International 2021; 30 (228): 187-188. Subscribers only.

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See also:

"Weekly methotrexate:
welcome measures
to prevent fatal errors"
Prescrire International 2020;
29 (216): 154-155.
Pdf, subscribers only

"Oral methotrexate:
risk of a fatal overdose"
(May 2013)

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