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Background: Efficacy of methotrexate in ankylosing spondylitis (AS) is disputable. Nevertheless, methotrexate is still used for disease-modifying therapy of AS. Aim: To assess efficacy and safety of methotrexate in AS patients. Materials and methods: It was an open comparative study of efficacy of methotrexate (n=12) versus standard therapy (n=12) in AS patients. Results: Negative results of methotrexate therapy were obtained. In the majority of patients methotrexate therapy was associated with increased joint pain, swelling and morning stiffness as well as elevation of erythrocyte sedimentation rate, fever and visceritis. Worsening of symptoms was regarded as exacerbation of inflammatory process. The study was terminated prematurely. Conclusion: Methotrexate demonstrated no therapeutic effect in AS patients. In AS, methotrexate should be administrated under close physician control in order to ensure treatment safety

About the authors

A. V. Orlov-Morozov

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Author for correspondence.
Email: orlovmorozov@inbox.ru
MD, PhD, rheumatologist, Internal Diseases Department No.1 Russian Federation


  1. Creemers MC, Franssen MJ, van de Putte LB, Gribnau FW, van Riel PL. Methotrexate in severe ankylosing spondylitis: an open study. J Rheumatol. 1995;22(6):1104–7.
  2. Ferraz MB, da Silva HC, Atra E. Low dose methotrexate with leucovorin rescue in AS. J Rheumatol. 1991;18(1):146–7.
  3. Handler RP. Favorable results using methotrexate in the treatment of patients with ankylosing spondylitis. Arthritis Rheum. 1989;32(2):234.
  4. Dubost JJ, Soubrier M, Sauvezie B. Treatment of refractory spondylarthropathies. Presse Med. 1998;27(4):175–80.
  5. Toussirot E, Wendling D. Current guidelines for the drug treatment of ankylosing spondylitis. Drugs. 1998;56(2):225–40.
  6. Toussirot E, Wendling D. L’utilisation du methotrexate dans les spondylarthropathies. Revue de la litterature. Rev Med Interne. 1996;17(4):333–9.
  7. Yang Z, Zhao W, Liu W, Lv Q, Dong X. Efficacy evaluation of methotrexate in the treatment of ankylosing spondylitis using meta-analysis. Int J Clin Pharmacol Ther. 2014;52(5):346–51.
  8. Relas H, Kautiainen H, Puolakka K, Virta LJ, Leirisalo-Repo M. Survival of disease-modifying antirheumatic drugs used as the first antirheumatic medication in the treatment of ankylosing spondylitis in Finland. A nationwide population-based register study. Clin Rheumatol. 2014;33(8):1135–8.
  9. Бунчук НВ, Бадокин ВВ, Коротаева ТВ. Анкилозирующий спондилит. В: Насонов ЕЛ, Насонова ВА, ред. Ревматология: национальное руководство. М.: ГЭОТАР-Медиа; 2008. (Bunchuk NV, Badokin VV, Korotaeva TV. Ankylosing spondylitis. In: Nasonov EL, Nasonova VA, editors. Rheumatology: national guidelines. Moscow: GEOTAR-Media; 2008. Russian).
  10. Эрдес ШФ, Волнухин ЕВ, Галушко ЕА. Лечение больных анкилозирующим спондилитом в реальной практике врача-ревматолога в России. Научно-практическая ревматология. 2013;(1):15–20.
  11. (Erdes ShF, Volnukhin EV, Galushko EA. [Treatment in patients with ankylosing spondylitis in the real clinical practice of a rheumatologist in Russia]. Nauchno-prakticheskaya revmatologi-ya. 2013;(1):15–20. Russian).
  12. Maillot F, Machet L, Hommeja-Marin H, Vaillant L. Hyperthermie due au methotrexate au cours d’une maladie de Still. Therapie. 1994;49(6):520–1.
  13. Halla JT, Hardin JG. Underrecognized post-dosing reactions to methotrexate in patients with rheumatoid arthritis. J Rheumatol. 1994;21(7):1224–6.
  14. Abu-Shakra M, Nicol P, Urowitz MB. Accelerated nodulosis, pleural effusion, and pericardial tamponade during methotrexate therapy. J Rheumatol. 1994;21(5):934–7.
  15. Didry C, Combe B, Sany J. Absence of efficacy of methotrexate on systemic manifestations of rheumatoid arthritis. Clin Rheum Belg. 1990;9(1):138.
  16. Wilson K, Abeles M. A 2 year, open ended trial of methotrexate in systemic lupus erythematosus. J Rheumatol. 1994;21(9): 1674–7.
  17. Fielder AH, Walport MJ, Batchelor JR, Rynes RI, Black CM, Dodi IA, Hughes GR. Family study of the major histocompatibility complex in patients with systemic lupus erythematosus: importance of null alleles of C4A and C4B in determining disease susceptibility. Br Med J (Clin Res Ed). 1983;286(6363):425–8.
  18. Lamers MC. Factors influencing the development of immune-complex diseases. Allergy. 1981;36(8):527–35.
  19. Alarcón GS, Schrohenloher RE, Bartolucci AA, Ward JR, Williams HJ, Koopman WJ. Suppression of rheumatoid factor production by methotrexate in patients with rheumatoid arthritis. Evidence for differential influences of therapy and clinical status on IgM and IgA rheumatoid factor expression. Arthritis Rheum. 1990;33(8):1156–61.
  20. Feldman D, Feldman D, Ginzler E, Kaplan D. Rheumatoid factor in patients with systemic lupus erythematosus. J Rheumatol. 1989;16(5): 618–22.
  21. Petty RE, Hunt DW, Rosenberg AM. Antibodies to type IV collagen in rheumatic diseases. J Rheumatol. 1986;13(2):246–53.
  22. Rowley M, Tait B, Mackay IR, Cunningham T, Phillips B. Collagen antibodies in rheumatoid arthritis. Significance of antibodies to denatured collagen and their association with HLA-DR4. Arthritis Rheum. 1986;29(2): 174–84.

Copyright (c) 2016 Orlov-Morozov A.V.

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