The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.
Adjunctive methotrexate for treatment of giant cell arteritis: An individual patient data meta‐analysis
Abstract
Objective: To reevaluate the efficacy and safety of adjunctive low‐dose methotrexate (MTX) in giant cell arteritis (GCA). Methods: An individual patient data meta‐analysis of 3 randomized placebo‐controlled trials in patients with newly diagnosed GCA was performed. Treatment consisted of initial high‐dose corticosteroids and randomly assigned oral MTX therapy (7.5–15 mg/week) or placebo. Time‐to‐event outcomes were compared between groups using Cox proportional hazards models stratified by trial, and continuous outcomes were compared by calculating weighted mean differences. Results: The combined data set comprised 161 patients, of whom 84 received MTX and 77 received placebo. The mean duration of followup was 54.7 weeks (SD 39.2 weeks). Hazard ratios (HRs) for a first and second relapse of GCA were 0.65 ( P = 0.04) and 0.49 ( P = 0.02), respectively, in patients receiving MTX as compared with patients receiving placebo. Accordingly, a predicted 3.6 individuals (95% confidence interval [95% CI] 2.2–56.8) and 4.7 individuals (95% CI 3.3–21.9) need to be treated with MTX to prevent the occurrence of one first or one second relapse, respectively, up to 48 weeks. Use of MTX resulted in a reduction in the corticosteroid cumulative dose by 842 mg within 48 weeks ( P < 0.001). Moreover, MTX treatment was associated with a higher probability of achieving sustained discontinuation of corticosteroids for ≥24 weeks (HR 2.84, P = 0.001). Dropout rates and occurrence of adverse events did not differ between treatment groups. Conclusion: In GCA, adjunctive treatment with MTX lowers the risk of relapse and reduces exposure to corticosteroids. These findings indicate that MTX could be considered as a therapeutic option in addition to standard‐of‐care treatment with corticosteroids for patients with GCA.
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Cites
Polymyalgia Rheumatica and Giant-Cell Arteritis
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Meta-analysis of the literature or of individual patient data: is there a difference?
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Glucocorticoid therapy in giant cell arteritis: Duration and adverse outcomes
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Self-citationTreatment of glucocorticoid‐resistant or relapsing takayasu arteritis with methotrexate
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Giant-Cell Arteritis and Polymyalgia Rheumatica
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Giant Cell Arteritis and Polymyalgia Rheumatica
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Cited by
Kleindorfer, D. O., Towfighi, A., Chaturvedi, S., Cockroft, K. M., Gutierrez, J., Lombardi-Hill, D., Kamel, H., Kernan, W. N., Kittner, S. J., Leira, E. C., et al. (2021) · Stroke · doi:10.1161/str.0000000000000375 · Cited by 3,237
Polymyalgia rheumatica and giant-cell arteritis
Salvarani, C., Cantini, F., & Hunder, G. G. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61077-6 · Cited by 767
Polymyalgia Rheumatica and Giant Cell Arteritis
Ettlinger, R. E., Hunder, G. G., & Ward, L. E. (1978) · Annual Review of Medicine · doi:10.1146/annurev.me.29.020178.000311 · Cited by 687
Villiger, P. M., Adler, S., Kuchen, S., Wermelinger, F., Dan, D., Fiege, V., Bütikofer, L., Seitz, M., & Reichenbach, S. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00560-2 · Cited by 577
Koźmiński, P., Halik, P. K., Chesori, R., & Gniazdowska, E. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21103483 · Cited by 326
Metadata
- Authors
- Mahr, A. D., Jover, J. A., Spiera, R. F., Hernández‐García, C., Fernández‐Gutiérrez, B., LaValley, M. P., & Merkel, P. A.
- Venue
- Arthritis & Rheumatism
- Publisher
- Wiley
- Published
- 2007-07-30
- Volume
- 56
- Issue
- 8
- Pages
- 2789-2797
- ISSN
- 0004-3591 (ISSN-L)
- 1529-0131
- OpenAlex
- W2053328369
- Cited by
- 622
- References
- 19
- FWCI
- 19.01
- Type
- journal article
- Language
- en
- Open access
- closed
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