Methotrexate prednisone rheumatoid arthritis

Referral to a specialist in internal medicine or rheumatology can help with patient selection, assessment and subsequent follow-up. Concurrent treatment with methotrexate can reduce the duration and toxicity of prednisone corticosteroid therapy and should be considered. Practice implications: Biopsy-proven temporal arteritis should continue to be treated initially with high-dose prednisone therapy. Further studies will reveal whether a different regimen of methotrexate or another corticosteroid-sparing agent can provide similar effectiveness, with fewer side effects. Although the adverse effects associated with methotrexate in this study underline the need for due caution, the larger experience with it in the treatment of rheumatoid arthritis suggests that adverse effects can be kept to a minimum with careful patient selection, folic acid supplementation and close monitoring.