Interactions Among Low Dose of Methotrexate and Drugs Used in the Treatment of Rheumatoid Arthritis

Overview

Journal Adv Pharmacol Sci

Date 2013 Jun 6

PMID 23737767

Citations 16

Authors

Marinella Patane

Miriam Ciriaco

Serafina Chimirri

Francesco Ursini

Saverio Naty

Rosa Daniela Grembiale

Luca Gallelli

Giovambattista De Sarro

Emilio Russo

Affiliations

Soon will be listed here.

Abstract

Methotrexate (MTX) is a nonbiological disease-modifying antirheumatic drug that has shown both a good control of clinical disease and a good safety. Usually drug-drug interactions (DDIs) represent the most limiting factor during the clinical management of any disease, in particular when several drugs are coadministered to treat the same disease. In this paper, we report the interactions among MTX and the other drugs commonly used in the management of rheumatoid arthritis. Using Medline, PubMed, Embase, Cochrane libraries, and Reference lists, we searched for the articles published until June 30, 2012, and we reported the most common DDIs between MTX and antirheumatic drugs. In particular, clinically relevant DDIs have been described during the treatment with MTX and NSAIDs, for example, diclofenac, indomethacin, or COX-2 inhibitors, and between MTX and prednisone or immunosuppressant drugs (e.g., leflunomide and cyclosporine). Finally, an increase in the risk of infections has been recorded during the combination treatment with MTX plus antitumor necrosis factor- α agents. In conclusion, during the treatment with MTX, DDIs play an important role in both the development of ADRs and therapeutic failure.

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References

Hill R, Topliss D, Purcell P . Pancytopenia associated with leflunomide and methotrexate. Ann Pharmacother. 2002; 37(1):149. DOI: 10.1345/aph.1C293. View

Gallelli L, Guadagnino V, Caroleo B, Marigliano N, De Sarro G . Cutaneous ulceration induced by interferon alfa. Ann Pharmacother. 2004; 38(1):173-4. DOI: 10.1345/aph.1D198. View

Saag K, Teng G, Patkar N, Anuntiyo J, Finney C, Curtis J . American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum. 2008; 59(6):762-84. DOI: 10.1002/art.23721. View

Gerards A, Landewe R, Prins A, Bruyn G, Goei The H, Laan R . Cyclosporin A monotherapy versus cyclosporin A and methotrexate combination therapy in patients with early rheumatoid arthritis: a double blind randomised placebo controlled trial. Ann Rheum Dis. 2003; 62(4):291-6. PMC: 1754491. DOI: 10.1136/ard.62.4.291. View

Schwartz J, Agrawal N, Wong P, Miller J, Bachmann K, Marbury T . Examination of the effect of increasing doses of etoricoxib on oral methotrexate pharmacokinetics in patients with rheumatoid arthritis. J Clin Pharmacol. 2009; 49(10):1202-9. DOI: 10.1177/0091270009338939. View

Gareri P, De Fazio P, Cotroneo A, Lacava R, Gallelli L, de Fazio S . Anticholinergic drug-induced delirium in an elderly Alzheimer's dementia patient. Arch Gerontol Geriatr. 2007; 44 Suppl 1:199-206. DOI: 10.1016/j.archger.2007.01.027. View

Gallelli L, de Fazio S, Corace E, De Sarro G, Garcia C, De Fazio P . Generalised urticaria in a young woman treated with clomipramine and after ingestion of codfish. Pharmacopsychiatry. 2006; 39(4):154-6. DOI: 10.1055/s-2006-946707. View

Gallelli L, Gallelli A, Vero G, Roccia F, Pelaia G, De Sarro G . Acute renal failure probably induced by prulifloxacin in an elderly woman : a first case report. Clin Drug Investig. 2006; 26(1):49-53. DOI: 10.2165/00044011-200626010-00007. View

Kruger K, Wollenhaupt J, Albrecht K, Alten R, Backhaus M, Baerwald C . [German 2012 guidelines for the sequential medical treatment of rheumatoid arthritis. Adapted EULAR recommendations and updated treatment algorithm]. Z Rheumatol. 2012; 71(7):592-603. DOI: 10.1007/s00393-012-1038-0. View

10.

Karim A, Tolbert D, Hunt T, Hubbard R, Harper K, Geis G . Celecoxib, a specific COX-2 inhibitor, has no significant effect on methotrexate pharmacokinetics in patients with rheumatoid arthritis. J Rheumatol. 1999; 26(12):2539-43. View

11.

Segal R, Mozes E, Yaron M, Tartakovsky B . The effects of methotrexate on the production and activity of interleukin-1. Arthritis Rheum. 1989; 32(4):370-7. DOI: 10.1002/anr.1780320403. View

12.

Malysheva O, Wahle M, Wagner U, Pierer M, Arnold S, Hantzschel H . Low-dose prednisolone in rheumatoid arthritis: adverse effects of various disease modifying antirheumatic drugs. J Rheumatol. 2008; 35(6):979-85. View

13.

Bijlsma J . Disease control with glucocorticoid therapy in rheumatoid arthritis. Rheumatology (Oxford). 2012; 51 Suppl 4:iv9-13. DOI: 10.1093/rheumatology/kes086. View

14.

Elsby R, Fox L, Stresser D, Layton M, Butters C, Sharma P . In vitro risk assessment of AZD9056 perpetrating a transporter-mediated drug-drug interaction with methotrexate. Eur J Pharm Sci. 2011; 43(1-2):41-9. DOI: 10.1016/j.ejps.2011.03.006. View

15.

Gallelli L, Nardi M, Prantera T, Barbera S, Raffaele M, Arminio D . Retrospective analysis of adverse drug reactions induced by gemcitabine treatment in patients with non-small cell lung cancer. Pharmacol Res. 2004; 49(3):259-63. DOI: 10.1016/j.phrs.2003.10.001. View

16.

Callen J . Complications and adverse reactions in the use of newer biologic agents. Semin Cutan Med Surg. 2007; 26(1):6-14. DOI: 10.1016/j.sder.2006.12.002. View

17.

Clarke L, Kirwan J . Efficacy, safety and mechanism of action of modified-release prednisone in rheumatoid arthritis. Ther Adv Musculoskelet Dis. 2012; 4(3):159-66. PMC: 3400105. DOI: 10.1177/1759720X12441274. View

18.

Luong B, Chong B, Lowder D . Treatment options for rheumatoid arthritis: celecoxib, leflunomide, etanercept, and infliximab. Ann Pharmacother. 2000; 34(6):743-60. DOI: 10.1345/aph.19344. View

19.

Boers M . [Prednisone for rheumatoid arthritis: the detriment of the doubt]. Ned Tijdschr Geneeskd. 2012; 155(32):A5069. View

20.

Zhou H, Mayer P, Wajdula J, Fatenejad S . Unaltered etanercept pharmacokinetics with concurrent methotrexate in patients with rheumatoid arthritis. J Clin Pharmacol. 2004; 44(11):1235-43. DOI: 10.1177/0091270004268049. View