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《Rheumatism and Arthritis》 2019-02
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Clinical Research on Methotrexate Chronotherapy in Rheumatoid Arthritis

WANG Zhi-qiang;ZHANG Xiao-gang;MA Xu;ZHANG Ming-ming;LIU Yan-qing;LI Zhen-bin;  
Objective:To investigate the effect of methotrexate by different administration times on the outcomes of rheumatoid arthritis,and to determine the best time to use methotrexate in order to provide the basis for clinical treatment.Methods:Sixty-two patients with rheumatoid arthritis were randomly divided into methotrexate 8 ∶ 00 group and methotrexate 20 ∶ 00 group,31 cases in each group.Two groups of patients were given methotrexate treatment at the corresponding time point,the other treatments were the same,both of them for 12 weeks.Clinical evaluations and laboratory index detection were performed at 4,8,12 weeks of treatment.Adverse events were recorded during therapy.Results:There were 30 cases to complete the study in each group separately.The DAS28-ESR of 8,12 weeks of treatment was significantly lower than that of baseline in both groups(P 0.01).The difference of the DAS28-ESR between two groups was remarkable after 12 weeks treatment.At 4,8,12 weeks of treatment,the numbers of patients reaching ACR20,ACR50 and ACR70 in methotrexate 20 ∶ 00 group were higher than those in methotrexate 8 ∶ 00 group at the same times,but only statistically significant difference of ACR50 at 12 weeks was found(P 0.05).The clinical and laboratory indexes of the two groups were improved with the extension of time,but there was no significant difference between the two groups at each time point(P 0.05).The adverse events were mild in both groups,the incidence of gastrointestinal discomfort in the methotrexate 20 ∶ 00 group was significantly lower than that in the methotrexate 8 ∶ 00 group(P 0.05).Conclusion:The efficacy of methotrexate administration at different times in the treatment of rheumatoid arthritis is different.Methotrexate administration at 20 ∶00 may be more effective in controlling disease activity in patients with rheumatoid arthritis,which needs further study to confirm.
【Fund】: 河北省科技厅科技计划项目(142777103D)
【CateGory Index】: R593.22
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【Citations】
Chinese Journal Full-text Database 1 Hits
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【Secondary Citations】
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9 LIU Tian1,WANG Xiu-ru1,AN Yuan1,ZHOU Yun-shan1,ZHANG Xiao-ying1,DUAN Tian-jiao1,ZHU Jia-xin1,LI Xiao-feng2,WANG Li-zhi2,WANG Cai-hong2,WANG Yong-fu3,YANG Rong3,WANG Guo-chun4,LU Xin4,ZHU Ping5,CHEN Li-na5,JIN Hong-tao6,LIU Xiang-yuan7,SUN Lin7,CHEN Hai-ying8,CUI Liu-fu9,SHU Rong9,LIU Bai-lu9,ZHANG Zhuo-li10,LI Guang-tao10,LI Zhen-bin11,YANG Jing11,LI Jun-fang12,JIA Bin12,ZHANG Feng-xiao13,TAO Jie-mei13,HAN Shu-ling14,LIN Jin-ying15,WEI Mei-qiu15,LIU Xiao-min16,KE Dan16,HU Shao-xian17,YE Cong17,YANG Xiu-yan18,LI Hao18,HUANG Ci-bo19,GAO Ming19,LAI Pei19,LI Xing-fu20,SONG Li-jun20,WANG Yi21,WANG Xiao-yuan21,MU Rong1,SU Yin1,LI Zhan-guo1(1.Department of Rheumatology and Immunology,Peking University People's Hospital,Beijing 100044,China;2.Department of Rheumatology and Immunology,Shanxi Medical University Second Hospital,Taiyuan 030001,China;3.Department of Rheumatology and Immunology,The First Affiliated Hospital of Baotou Medical College,Baotou 014010,China;4.Department of Rheumatology and Immunology,China-Japan Friendship Hospital,Beijing 100029,China;5.Department of Rheumatology and Immunology,Xijing Hospital,The Fourth Military Medical University,Xi'an 710032,China;6.Department of Rheumatology and Immunology,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;7.Department of Rheumatology and Immunology,Peking University Third Hospital,Beijing 100191,China;8.Department of Rheumatology and Immunology,The Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;9.Department of Rheumatology and Immunology,Kailuan Hospital of North China Coal Hospital,Tangshan 063000,China;10.Department of Rheumatology and Immunology,Peking University First Hospital,Beijing 100034,China;11.Department of Rheumatology and Immunology,Bethune International Peace Hospital,Shijiazhuang 050082,China;12.Department of Rheumatology and Immunology,Hebei Handan Central Hospital,Handan 056001,China;13.Department of Rheumatology and Immunology,Hebei People's Hospital,Shijiazhuang 050051,China;14.Department of Rheumatology and Immunology,Peking University Shougang Hospital,Beijing 100144,China;15.Department of Rheumatology and Immunology,The People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;16.Department of Rheumatology and Immunology,Beijing Shunyi Hospital of China Medical University,Beijing 101300,China;17.Department of Rheumatology and Immunology,Tongji Hospital of Tongji Medical College of Huazhong University of Science & Technology,Wuhan 430030,China;18.Department of Rheumatology and Immunology,First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;19.Department of Rheumatology and Immunology,Beijing Hospital,Beijing 100730,China;20.Department of Rheumatology and Immuno-logy,Qilu Hospital of Shandong University,Jinan 250012,China;21.Department of Rheumatology and Immunology,Lanzhou University Second Hospital,Lanzhou 730030,China);Sulphasalazine in patients with rheumatoid arthritis in China:a cross-sectional study[J];北京大学学报(医学版);2012-02
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