The full text of this article hosted at iucr.org is unavailable due to technical difficulties.

Article
Free Access

Long‐Term Prospective Study of Methotrexate in the Treatment of Rheumatoid Arthritis

Michael E. Weinblatt MD

Corresponding Author

Department of Rheumatology and Immunology, the Department of Radiology, and the Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Department of Rheumatology and Immunology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115
Search for more papers by this author
Barbara N. Weissman MD

Department of Rheumatology and Immunology, the Department of Radiology, and the Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Search for more papers by this author
Donald E. Holdsworth MD

Department of Rheumatology and Immunology, the Department of Radiology, and the Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Search for more papers by this author
Patricia A. Fraser MD, MPH

Department of Rheumatology and Immunology, the Department of Radiology, and the Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Search for more papers by this author
Agnes L. Maier BA

Department of Rheumatology and Immunology, the Department of Radiology, and the Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Search for more papers by this author
Kenneth R. Falchuk MD

Department of Rheumatology and Immunology, the Department of Radiology, and the Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Search for more papers by this author
Jonathan S. Cobly MD

Department of Rheumatology and Immunology, the Department of Radiology, and the Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Search for more papers by this author
First published: February 1992
Cited by: 130

Abstract

Objective. To determine the long‐term efficacy and safety of low‐dose methotrexate (MTX) in rheumatoid arthritis (RA).

Methods. Eighty‐four—month open prospective trial at a single academic rheumatology center.

Results. Twenty‐six patients were enrolled in a prospective study of the long‐term efficacy of MTX in RA; a significant improvement had been demonstrated after 36 months of therapy. Twelve patients remained in the study at the 84‐month visit; the mean weekly dosage of MTX was 10.2 mg. A significant improvement was still noted at 84 months in the number of painful joints, number of swollen joints, joint pain index, joint swelling index, and physician and patient global assessments. A 50% improvement in the joint pain index and joint swelling index was observed in more than 80% of the 12 patients still enrolled. A significant reduction in prednisone dosage was achieved; of 14 patients taking prednisone at entry, 7 had discontinued prednisone completely. Fourteen patients withdrew from the study: 10 between 0 and 36 months, and 4 between 36 and 84 months. Toxicity in 3 patients and visit noncompliance in 1 patient were the reasons for withdrawal between 36 and 84 months. At 84 months, 46% of the patients remained in the study; 11.5% had discontinued due to MTX toxicity.

Conclusion. The effectiveness of MTX in the treatment of RA continues to be demonstrated in this prospective study, after 84 months of treatment.

Number of times cited: 130

  • , Side effects of methotrexate therapy for rheumatoid arthritis: A systematic review, European Journal of Medicinal Chemistry, 10.1016/j.ejmech.2018.09.027, 158, (502-516), (2018).
  • , Methotrexate Liposomes - A Reliable Therapeutic Option, Liposomes, 10.5772/intechopen.68520, (2017).
  • , Neutropenia in the Elderly: A Rheumatology Perspective, Drugs & Aging, 10.1007/s40266-016-0383-0, 33, 8, (585-601), (2016).
  • , Discoveries of conventional synthetic disease modifying anti-rheumatic drugs – Serendipity or flawless reasoning?, Indian Journal of Rheumatology, 11, 1, (32), (2016).
  • , Landmark papers on the discovery of methotrexate for the treatment of rheumatoid arthritis and other systemic inflammatory rheumatic diseases: a fascinating story, International Journal of Rheumatic Diseases, 19, 9, (844-851), (2016).
  • , Pharmacotherapy of Rheumatoid Arthritis, Pharmaceutical Care Issues of Patients with Rheumatoid Arthritis, 10.1007/978-981-10-1421-5_2, (19-37), (2016).
  • , Effect of Methotrexate on Collagen-Induced Arthritis Assessed by Micro-Computed Tomography and Histopathological Examination in Female Rats, Biomolecules & Therapeutics, 23, 2, (195), (2015).
  • , Concurrent use of methotrexate and celecoxib increases risk of silent liver fibrosis in rheumatoid arthritis patients with subclinical reduced kidney function, Clinical Rheumatology, 33, 10, (1415), (2014).
  • , Treatment of Autoimmune Disease, The Autoimmune Diseases, 10.1016/B978-0-12-384929-8.00080-0, (1209-1220), (2014).
  • , Methotrexate in systemic lupus erythematosus: a systematic review of its efficacy, Lupus, 23, 3, (225), (2014).
  • , Antiviral Perspectives for Chikungunya Virus, BioMed Research International, 2014, (1), (2014).
  • , Structures of human folate receptors reveal biological trafficking states and diversity in folate and antifolate recognition, Proceedings of the National Academy of Sciences, 10.1073/pnas.1308827110, 110, 38, (15180-15188), (2013).
  • , Methylenetetrahydrofolate reductase polymorphisms, C677T and A1298C, are associated with methotrexate-related toxicities in Korean patients with rheumatoid arthritis, Rheumatology International, 32, 6, (1837), (2012).
  • , Alleviation of rheumatoid arthritis by cell-transducible methotrexate upon transcutaneous delivery, Biomaterials, 33, 5, (1563), (2012).
  • , Monitoring of Nonsteroidal Immunosuppressive Drugs in Patients With Lung Disease and Lung Transplant Recipients, Chest, 10.1378/chest.12-1044, 142, 5, (e1S-e111S), (2012).
  • , Efficacy and safety of methotrexate in articular and cutaneous manifestations of systemic lupus erythematosus, International Journal of Rheumatic Diseases, 15, 1, (62-68), (2011).
  • , Phase II trial of methotrexate in myasthenia gravis, Annals of the New York Academy of Sciences, 1275, 1, (23-28), (2012).
  • , Drug Monitoring in Systemic Lupus Erythematosus: A Systematic Review, Seminars in Arthritis and Rheumatism, 10.1016/j.semarthrit.2010.07.010, 40, 6, (559-575), (2011).
  • , Methotrexate Chronotherapy is Effective Against Rheumatoid Arthritis, Chronobiology International, 28, 3, (267), (2011).
  • , Observational Cross-Sectional Study Revealing Less Aggressive Treatment in Japanese Elderly Than Nonelderly Patients With Rheumatoid Arthritis, JCR Journal of Clinical Rheumatology, 16, 8, (370), (2010).
  • , Manifestations pulmonaires associées aux immunosuppresseurs utilisés dans les transplantations et les maladies auto-immunes, La Presse Médicale, 10.1016/j.lpm.2010.04.002, 39, 9, (878-886), (2010).
  • , Changes in Liver Biochemistry During Methotrexate Use for Inflammatory Bowel Disease, The American Journal of Gastroenterology, 10.1038/ajg.2010.21, 105, 7, (1620-1626), (2010).
  • , Differential influences of bucillamine and methotrexate on the generation of fibroblast-like cells from bone marrow CD34+ cells of rheumatoid arthritis patients, International Immunopharmacology, 9, 1, (86), (2009).
  • , Orbital sarcoid treatment, Expert Review of Ophthalmology, 3, 2, (219), (2008).
  • , Psoriatic arthritis, methotrexate and the liver--are rheumatologists putting their patients at risk?, Rheumatology, 47, 7, (939), (2008).
  • , Methotrexate Controversies, Drug-Induced Liver Disease, Second Edition, 10.3109/9781420021141-32, (683-705), (2013).
  • , Rheumatic Disease in the Elderly: Rheumatoid Arthritis, Rheumatic Disease Clinics of North America, 33, 1, (57), (2007).
  • , Durability of treatment with methotrexate in Venezuelan patients with rheumatoid arthritis, Rheumatology International, 10.1007/s00296-006-0261-x, 27, 6, (531-536), (2006).
  • , The Mechanism of Nephrotoxicity Formation of Methotrexate in STZ-Induced Hyperglycemic Rats, Journal of Life Science, 16, 2, (259), (2006).
  • , Methotrexate and Hepatic Toxicity in??Rheumatoid Arthritis and Psoriatic Arthritis, Clinical Drug Investigation, 26, 2, (55), (2006).
  • , The use of low dose methotrexate in rheumatoid arthritis—are we entering a new era of therapeutic drug monitoring and pharmacogenomics?, Biomedicine & Pharmacotherapy, 10.1016/j.biopha.2006.09.007, 60, 10, (678-687), (2006).
  • , Adalimumab for the treatment of rheumatoid arthritis, Therapy, 10.2217/14750708.2.1.13, 2, 1, (13-21), (2005).
  • , Adalimumab for the treatment of rheumatoid arthritis, Therapy, 10.1586/14750708.2.1.13, 2, 1, (13-21), (2005).
  • , The changing use of disease-modifying anti-rheumatic drugs in individuals with rheumatoid arthritis from the United Kingdom General Practice Research Database, Rheumatology, 10.1093/rheumatology/kei024, 44, 11, (1394-1398), (2005).
  • , A clinical trial of low dose methotrexate therapy in patients with rheumatoid arthritis, Japanese Journal of Clinical Immunology, 28, 6, (389), (2005).
  • , Rheumatic Disease in the Elderly: Rheumatoid Arthritis, Clinics in Geriatric Medicine, 21, 3, (513), (2005).
  • , The use of methotrexate in rheumatoid arthritis, Seminars in Arthritis and Rheumatism, 10.1016/j.semarthrit.2003.12.003, 34, 1, (465-483), (2004).
  • , A case of rheumatoid arthritis exhibiting accelerating rheumatoid pleurisy during low-dose weekly methotrexate therapy, Modern Rheumatology, 14, 5, (414), (2004).
  • , The natural history and prognosis of rheumatoid arthritis: association of radiographic outcome with process variables, joint motion and immune proteins, Scandinavian Journal of Rheumatology, 33, sup118, (1), (2004).
  • , Pulmonary Effects of Low-Dose Methotrexate Therapy, Clinical Pulmonary Medicine, 10.1097/01.cpm.0000140182.17091.ef, 11, 5, (307-317), (2004).
  • , Pharmacological treatment of established rheumatoid arthritis, Best Practice & Research Clinical Rheumatology, 10.1016/S1521-6942(03)00048-2, 17, 5, (811-829), (2003).
  • , Methotrexate in inflammatory eye disease, Ocular Immunology and Inflammation, 11, 2, (79), (2003).
  • , New Concepts in the Treatment of Rheumatoid Arthritis, Annual Review of Medicine, 54, 1, (197), (2003).
  • , Guidelines for monitoring of methotrexate therapy: “Evidence‐based medicine” outside of clinical trials, Arthritis & Rheumatism, 48, 10, (2706-2709), (2003).
  • , Methotrexate-Induced Pulmonary Lymphomaa, Chest, 123, 6, (2150), (2003).
  • , Advanced therapy for juvenile arthritis, Best Practice & Research Clinical Rheumatology, 16, 3, (361), (2002).
  • , Azathioprine or methotrexate in the treatment of patients with steroid‐dependent or steroid‐resistant ulcerative colitis: results of an open‐label study on efficacy and tolerability in inducing and maintaining remission, Alimentary Pharmacology & Therapeutics, 16, 10, (1751-1759), (2002).
  • , Radiographic outcome after three years of patients with early erosive rheumatoid arthritis treated with intramuscular methotrexate or parenteral gold. Extension of a one‐year double‐blind study in 174 patients, Rheumatology, 41, 2, (196), (2002).
  • , Low‐Dosage Methotrexate for Treatment and Maintenance of Remission in Patients with Inflammatory Bowel Disease, Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 22, 5, (613-620), (2012).
  • , Unwillingness of rheumatoid arthritis patients to risk adverse effects, Rheumatology, 41, 3, (253), (2002).
  • , Acute Myeloid Leukemia in the Setting of Low Dose Weekly Methotrexate Therapy for Rheumatoid Arthritis, Leukemia & Lymphoma, 42, 3, (371), (2001).
  • , Old and New Drugs Used in Rheumatoid Arthritis: A Historical Perspective, American Journal of Therapeutics, 10.1097/00045391-200103000-00007, 8, 2, (123-143), (2001).
  • , Additive combination of actarit and methotrexate in the treatment of refractory rheumatoid arthritis, Modern Rheumatology, 10, 2, (103), (2000).
  • , Response to methotrexate treatment is associated with reduced mortality in patients with severe rheumatoid arthritis, Arthritis & Rheumatism, 43, 1, (14-21), (2001).
  • , Tratamiento de la artritis reumatoide, Medicina Clínica, 114, 20, (777), (2000).
  • , A Comparison of Etanercept and Methotrexate in Patients with Early Rheumatoid Arthritis, New England Journal of Medicine, 343, 22, (1586), (2000).
  • , Methotrexate use in rheumatoid arthritis. A clinician's perspective, Immunopharmacology, 47, 2-3, (259), (2000).
  • , Low-dose methotrexate is ineffective in primary biliary cirrhosis: Long-term results of a placebo-controlled trial, Gastroenterology, 117, 2, (400), (1999).
  • , Long-term methotrexate (MTX) combination therapy versus MTX alone for active rheumatoid arthritis, Japanese Journal of Rheumatology, 9, 1, (31), (1999).
  • , Long-term methotrexate (MTX) combination therapy versus MTX alone for active rheumatoid arthritis, Japanese Journal of Rheumatology, 9, 1, (31), (1999).
  • , Low-dose methotrexate in primary biliary cirrhosis, Gastroenterology, 117, 6, (1510), (1999).
  • , Suppressive Influences of Methotrexate on the Generation of CD14 (+) Monocyte-Lineage Cells from Bone Marrow of Patients with Rheumatoid Arthritis, Clinical Immunology, 91, 1, (84), (1999).
  • , Effects of methotrexate on differentiation of monocytes and production of cytokine inhibitors by monocytes, Arthritis & Rheumatism, 41, 11, (2032-2038), (2004).
  • , Long-term exposure to methotrexate induces immunophenotypic changes, decreased methotrexate uptake and increased dihydrofolate gene copy number in jurkat T cells, International Journal of Immunopharmacology, 19, 11-12, (709), (1998).
  • , A Novel Non-polyglutamable Anti-folate, MX-68, Inhibits the Induction of Experimental Autoimmune Uveitis in Rats, Experimental Eye Research, 67, 1, (1), (1998).
  • , Methotrexate therapy in systemic-onset juvenile rheumatoid arthritis in Saudi Arabia: A retrospective analysis, Clinical Rheumatology, 17, 1, (52), (1998).
  • , Methotrexate in rheumatoid arthritis: An updatewith focus on mechanisms involved in toxicity, Seminars in Arthritis and Rheumatism, 27, 5, (277), (1998).
  • , METHOTREXATE AND EMERGING THERAPIES, Rheumatic Disease Clinics of North America, 24, 3, (651), (1998).
  • , The population pharmacokinetics of long-term methotrexate in rheumatoid arthritis, British Journal of Clinical Pharmacology, 46, 4, (369), (1998).
  • , Clinical, laboratory, radiographic, and histopathologic features of methotrexate‐associated lung injury in patients with rheumatoid arthritis. A multicenter study with literature review, Arthritis & Rheumatism, 40, 10, (1829-1837), (2005).
  • , The long‐term effect of methotrexate therapy on the liver in patients with juvenile rheumatoid arthritis, Arthritis & Rheumatism, 40, 12, (2226-2234), (2005).
  • , METHOTREXATE USE IN RHEUMATOID ARTHRITIS, Rheumatic Disease Clinics of North America, 23, 4, (779), (1997).
  • , DOES METHOTREXATE INCREASE THE RISK OF INFECTION OR MALIGNANCY?, Rheumatic Disease Clinics of North America, 23, 4, (955), (1997).
  • , METHOTREXATE PULMONARY TOXICITY, Rheumatic Disease Clinics of North America, 23, 4, (917), (1997).
  • , Methotrexate-induced pneumonitis in patients with rheumatoid arthritis and psoriatic arthritis: Report of five cases and review of the literature, Clinical Rheumatology, 16, 3, (296), (1997).
  • , Safty, efficacy, and mortality in a long‐term cohort of patients with rheumatoid arthritis taking methotrexate: Folloup after a mean of 13.3 years, Arthritis & Rheumatism, 40, 5, (984-985), (2005).
  • , HEMATOLOGIC COMPLICATIONS OF RHEUMATIC DISEASE THERAPIES, Rheumatic Disease Clinics of North America, 23, 2, (425), (1997).
  • , Lymphoma in patients with rheumatoid arthritis: Association with the disease state or methotrexate treatment with the disease state or methotrexate treatment, Seminars in Arthritis and Rheumatism, 26, 6, (794), (1997).
  • , Methotrexate use in systemic lupus erythematosus, Lupus, 6, 4, (385), (1997).
  • , METHOTREXATE HEPATOTOXICITY, Rheumatic Disease Clinics of North America, 23, 4, (883), (1997).
  • , TREATMENT OF RHEUMATOID ARTHRITIS, Medical Clinics of North America, 81, 1, (57), (1997).
  • , Cutaneous necrotizing vasculitis after low dose methotrexate therapy for rheumatoid arthritis: A possible manifestation of methotrexate hypersensitivity, Clinical Rheumatology, 16, 6, (623), (1997).
  • , Thrombocytopenia in patients with rheumatoid arthritis on long-term treatment with low dose methotrexate, Clinical Rheumatology, 15, 3, (266), (1996).
  • , Management of rheumatic diseases in children, The Indian Journal of Pediatrics, 63, 3, (305), (1996).
  • , Multiple Sclerosis: New Approaches to Immunotherapy, The Neuroscientist, 2, 2, (127), (1996).
  • , A limited sampling method to estimate methotrexate pharmacokinetics in patients with rheumatoid arthritis using a Bayesian approach and the population data modeling program P-PHARM, European Journal of Clinical Pharmacology, 49, 4, (285), (1996).
  • , Pulmonary Function in Patients Receiving Long-term Low-dose Methotrexate, Chest, 109, 4, (933), (1996).
  • , Thrombocytopenia in patients with rheumatoid arthritis on long-term treatment with low dose methotrexate, Clinical Rheumatology, 15, 2, (163), (1996).
  • , Methotrexate Update, Scandinavian Journal of Rheumatology, 25, 6, (341), (1996).
  • , Combination Therapy of Cyclosporine a with Methotrexate or Hydroxychloroquine in Refractory Rheumatoid Arthritis, Scandinavian Journal of Rheumatology, 25, 1, (16), (1996).
  • , In vitro and in vivo biological activities of a novel nonpolyglutamable anti-folate, MX-68, Immunopharmacology, 35, 1, (41), (1996).
  • , Long-term tolerability of methotrexate at doses exceeding 15 mg per week in rheumatoid arthritis, Rheumatology International, 10.1007/BF00290521, 15, 5, (195-200), (1996).
  • , The cost‐effectiveness of liver biopsy in rheumatoid arthritis patients treated with methotrexate, Arthritis & Rheumatism, 38, 3, (326-333), (2005).
  • , Low-dose (7.5 mg) oral methotrexate reduces the rate of progression in chronic progressive multiple sclerosis, Annals of Neurology, 37, 1, (30), (1995).
  • , Interstitial pneumonia due to cytomegalovirus following low-dose methotrexate treatment for rheumatoid arthritis, Arthritis & Rheumatism, 38, 2, (291), (1995).
  • , Clinical outcomes and documentation of partial beneficial effects of immunotherapy for multiple sclerosis, Annals of Neurology, 37, 1, (5-6), (2004).
  • , New Perspectives on Treating Rheumatoid Arthritis, New England Journal of Medicine, 333, 3, (183), (1995).
  • , Usefulness of the american college of rheumatology recommendations for liver biopsy in methotrexate‐treated rheumatoid arthritis patients, Arthritis & Rheumatism, 38, 8, (1115-1119), (2005).
  • , Methotrexate for the treatment of severe mucocutaneous lupus erythematosus, British Journal of Dermatology, 133, 2, (311), (1995).
  • , Reply, Arthritis & Rheumatism, 38, 8, (1173-1174), (2005).
  • , Experience with low-dose methotrexate: Toxicity, tolerability and effect on conventional patterns of drug therapy for inflammatory arthritis, Clinical Rheumatology, 14, 5, (544), (1995).
  • , End‐stage liver disease developing with the use of methotrexate in heterozygous α1‐antitrypsin deficiency, Arthritis & Rheumatism, 38, 7, (1014-1018), (2005).
  • , Category III Symptom-Modifying Antirheumatic Drugs, Clinical Immunotherapeutics, 3, 3, (196), (1995).
  • , Methotrexate for Chronic Diseases in Adults, New England Journal of Medicine, 332, 5, (330), (1995).
  • , Infections during low-dose methotrexate treatmentin rheumatoid arthritis, Seminars in Arthritis and Rheumatism, 24, 6, (411), (1995).
  • , Every‐other‐week methotrexate in patients with rheumatoid arthritis, Arthritis & Rheumatism, 38, 5, (601-607), (2005).
  • , Synovial tissue response to treatment with campath-1h, Arthritis & Rheumatism, 38, 2, (254), (1995).
  • , Methotrexate in rheumatoid arthritis. a five‐year prospective multicenter study, Arthritis & Rheumatism, 37, 10, (1492-1498), (2005).
  • , Methotrexate, Clinical Immunotherapeutics, 1, 3, (217), (1994).
  • , Mechanisms of Methotrexate Action in Rheumatoid Arthritis, Arthritis & Rheumatism, 37, 2, (193-200), (2005).
  • , The value of C-reactive protein measurement in rheumatoid arthritis, Seminars in Arthritis and Rheumatism, 24, 2, (91), (1994).
  • , Second-Line Drug Therapy for Rheumatoid Arthritis, New England Journal of Medicine, 330, 19, (1368), (1994).
  • , Low-dose methotrexate in rheumatic diseases—Efficacy, side effects, and risk factors for side effects, Seminars in Arthritis and Rheumatism, 23, 5, (310), (1994).
  • , Methotrexate for Rheumatoid Arthritis, Arthritis & Rheumatism, 37, 3, (316-328), (2005).
  • , Choroidal Infiltrates as the Initial Manifestation of Lymphoma in Rheumatoid Arthritis After Treatment With Low-Dose Methotrexate, Mayo Clinic Proceedings, 69, 3, (258), (1994).
  • , On the Course of Seropositive Rheumatoid Arthritis during and after Long-term Gold Therapy, Scandinavian Journal of Rheumatology, 23, 5, (223), (1994).
  • , The lag time between onset of symptoms and diagnosis of rheumatoid arthritis, Arthritis & Rheumatism, 37, 6, (814), (1994).
  • , Determinants of serious liver disease among patients receiving low‐dose methotrexate for rheumatoid arthritis, Arthritis & Rheumatism, 36, 3, (329-335), (2005).
  • , Limitations of randomized clinical trials to recognize possible advantages of combination therapies in rheumatic diseases, Seminars in Arthritis and Rheumatism, 23, 2, (2), (1993).
  • , Bioequivalence of Two Methotrexate Formulations in Psoriatic and Cancer Patients, Annals of Pharmacotherapy, 27, 12, (1434), (1993).
  • , Effects of administration of an anti‐cd5 immunoconjugate in rheumatoid arthritis. results of two phase ii studies, Arthritis & Rheumatism, 36, 5, (620-630), (2005).
  • , Low‐dose methotrexate with leucovorin (folinic acid) in the management of rheumatoid arthritis. results of a multicenter randomized, double‐blind, placebo‐controlled trial, Arthritis & Rheumatism, 36, 6, (795-803), (2005).
  • , Early, aggressive therapy for rheumatoid arthritis: Concerns, descriptions, and estimate of outcome, Seminars in Arthritis and Rheumatism, 23, 2, (26), (1993).
  • , The effects of drug therapy on radiographic progression of rheumatoid arthritis. results of a 36‐week randomized trial comparing methotrexate and auranofin, Arthritis & Rheumatism, 36, 5, (613-619), (2005).
  • , Juvenile Rheumatoid Arthritis, Pediatric Rheumatology for the Practitioner, 10.1007/978-1-4757-6150-4_3, (231-359), (1993).
  • , Methotrexate for Juvenile Rheumatoid Arthritis, New England Journal of Medicine, 326, 16, (1077), (1992).
  • , Methotrexate for Juvenile Rheumatoid Arthritis, New England Journal of Medicine, 327, 12, (893), (1992).
  • , Disease Modification in Rheumatoid Arthritis with Special Reference to Cyclosporin A, Scandinavian Journal of Rheumatology, 21, sup95, (19), (1992).
  • , Molecular mechanism of methotrexate action in inflammation, Inflammation, 10.1007/BF00918968, 16, 5, (411-423), (1992).
  • , Methotrexate Treatment Causes Early Onset of Disease in a Mouse Model of Ross River Virus-Induced Inflammatory Disease through Increased Monocyte Production, PLoS ONE, 10.1371/journal.pone.0071146, 8, 8, (e71146), (2013).