{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T05:18:34Z","timestamp":1779340714622,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,6,4]],"date-time":"2014-06-04T00:00:00Z","timestamp":1401840000000},"content-version":"vor","delay-in-days":7885,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[1992,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objective<\/jats:italic>. To identify alternatives to daily low\u2010dose cyclophosphamide (CYC) in the treatment of Wegener's granulomatosis (WG).<\/jats:p><jats:p><jats:italic>Methods<\/jats:italic>. An open\u2010label pilot study of weekly low\u2010dose methotrexate (MTX) plus glucocorticoids (GC) for treatment of patients with WG was performed. Twenty\u2010nine patients who did not have immediately life\u2010threatening disease were included. Outcome was determined by clinical characteristics, pathologic findings, course of illness, laboratory and radiographic findings, and successful withdrawal of GC therapy.<\/jats:p><jats:p><jats:italic>Results<\/jats:italic>. Weekly administration of MTX (at a mean stable dosage of 20 mg) and GC resulted in marked improvement in 76% of the 29 patients. Remission was achieved in 69% of the patients, 7% improved but had intermittent smoldering disease that precluded total withdrawal of GC, and 17% had progressive disease within 2\u20136 months of starting the study treatment. Two patients who initially achieved remission later had relapses after GC was discontinued. Of those who remain in remission (mean followup time 14.5 months), 72% have not required GC for a mean period of 10 months.<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>. Although standard therapy for WG (daily CYC and GC) has dramatically improved outcome in this often\u2010fatal disease, treatment morbidity has led to attempts to identify effective interventions that have less toxicity. Weekly low\u2010dose MTX was shown in this study to be a feasible alternative to CYC in patients whose illness was not immediately life\u2010threatening or in whom prior CYC treatment was ineffective or produced serious toxicity. Although these results are preliminary, they are encouraging and justify further studies in which MTX, CYC, and other alternative therapeutic approaches are compared concurrently.<\/jats:p>","DOI":"10.1002\/art.1780351113","type":"journal-article","created":{"date-parts":[[2014,6,4]],"date-time":"2014-06-04T10:48:48Z","timestamp":1401878928000},"page":"1322-1329","source":"Crossref","is-referenced-by-count":181,"title":["The treatment of wegener's granulomatosis with glucocorticoids and methotrexate"],"prefix":"10.1002","volume":"35","author":[{"given":"Gary S.","family":"Hoffman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randi Y.","family":"Leavitt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gail S.","family":"Kerr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony 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