2018 Volume 30 Issue 1 Pages 5-11
Methotrexate (MTX) is the anchor drug in the treatment for patients with rheumatoid arthritis (RA). The approved weekly dose and frequencies of some adverse reactions, however, are different between in Japan and American/European countries. The use of high doses of MTX (9-16 mg/week) was approved in 2011, and then the Japan College of Rheumatology published the clinical practice guideline of MTX for patients with rheumatoid arthritis. In the version updated in 2016, revisions included statements regarding new clinical evidences of high dose MTX use including rapid dose escalation, screening for the prevention of tuberculosis and hepatitis B virus reactivation, and MTX-associated lymphoproliferative disorders. Whereas RA treatment strategy is changing, MTX treatment is also critical and always updated. Japanese rheumatologists should be well informed about the current knowledge and endeavor to develop new evidence of MTX use in Japanese patients.
