甲氨蝶呤治疗类风湿关节炎所致不良反应研究进展

Research progress in adverse reactions caused by methotrexate in the treatment of rheumatoid arthritis

类风湿关节炎是最常见的炎性关节病,目前尚无根治的办法,其治疗目的在于改善滑膜炎症并延缓关节破坏,通常推荐活动性类风湿关节炎患者在疾病早期积极使用抗风湿药物。甲氨蝶呤是抗风湿药物的首选,但其具有多种不良反应,且轻重程度差异很大。基于对甲氨蝶呤在类风湿关节炎治疗时严重不良反应的担忧,我国甲氨蝶呤的使用率低于国际水平。本文总结了甲氨蝶呤治疗类风湿关节炎所致不良反应的最新认识,以期为临床上甲氨蝶呤的安全使用提供帮助。

Rheumatoid arthritis(RA)is the most common inflammatory joint disease and there is currently no cure for it.The treatment of RA is to control synovitis and prevent joint damage.It′s recommended that patients with active RA should be treated with disease-modifying antirheumatic drugs(DMARDs)at the earlier stage of disease.The most commonly used DMARD in the initial treatment of RA is methotrexate(MTX),but it can be associated with a variety of adverse effects over a wide range of severity.Based on concerns about the serious adverse reactions of MTX in the treatment of RA,the level of MTX use in our country is lower than the international level.This article summarizes the latest understanding of the adverse reactions caused by MTX in the treatment of RA,in order to provide reference for the safe use of MTX in clinics.