{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T08:39:20Z","timestamp":1782290360825,"version":"3.54.5"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,12,20]],"date-time":"2012-12-20T00:00:00Z","timestamp":1355961600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of the New York Academy of Sciences"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:p>Prednisone is a frequently used treatment for myasthenia gravis (MG) but it has numerous side effects. Methotrexate is a selective inhibitor of dihydrofolate reductase and lymphocyte proliferation and is an effective immuosuppressive medication for autoimmune diseases. Given the negative results of the mycophenolate mofetil study, search for an effective immunosuppressant drug therapy is ongoing. The objective is to determine if oral methotrexate is safe and effective for MG patients who take prednisone. We have initiated a randomized, double\u2010blind, placebo\u2010controlled multicenter trial of methotrexate versus placebo in patients taking at least 10 mg\/day of prednisone at enrollment. The methotrexate dose is increased to 20 mg and the prednisone dose is adjusted per protocol during the study. Clinical and laboratory evaluations are performed monthly for 12 months, with the primary efficacy measure being the nine\u2010month prednisone area under the curve (AUC) from months 3 to 12. Secondary outcome measures include MG outcomes, quality of life measures, and a polyglutamation biomarker assay. A total of 18 U.S. sites and 2 Canadian sites are participating, with 48 screened cases, 42 enrolled, with 19 still active in the study.<\/jats:p>","DOI":"10.1111\/j.1749-6632.2012.06804.x","type":"journal-article","created":{"date-parts":[[2012,12,21]],"date-time":"2012-12-21T22:28:36Z","timestamp":1356128916000},"page":"23-28","source":"Crossref","is-referenced-by-count":17,"title":["Phase II trial of methotrexate in myasthenia gravis"],"prefix":"10.1111","volume":"1275","author":[{"given":"Mamatha","family":"Pasnoor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianghua","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Herbelin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen","family":"Dimachkie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Barohn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Muscle Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,12,20]]},"reference":[{"issue":"1","key":"e_1_2_7_2_2","first-page":"107","article-title":"A trial of mycophenolate mofetil (MMF) with prednisone as initial immunotherapy in myasthenia gravis (MG) [abstract]","volume":"62","author":"Sanders D.","year":"2007","journal-title":"Neurology"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000312374.95186.cc"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1405.031"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000312373.67493.7f"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310301"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/anr.1780320903"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310501"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.026120"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.55.4.237"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780341006"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/anr.1780320403"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780350202"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.56.11.1217"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410370108"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.47.5.1153"},{"issue":"1","key":"e_1_2_7_17_2","first-page":"300","article-title":"Methotrexate for treatment of myasthenia gravis","volume":"62","author":"Abdou A.M.","year":"2007","journal-title":"Neurology"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2008.10.138"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-11-97"},{"issue":"3","key":"e_1_2_7_20_2","first-page":"A54","article-title":"Methotrexate in the treatment of myasthenia gravis","volume":"72","author":"Raja F.M.","year":"2009","journal-title":"Neurology"},{"key":"e_1_2_7_21_2","first-page":"1209","volume-title":"The Pharmalogical Basis of Therapeutics","author":"Calabresi P.","year":"1990"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI112088"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M401725200"},{"key":"e_1_2_7_24_2","first-page":"5538","article-title":"Wild type breast cancer resistance protein (BCRP\/ABCG2) is a methotrexate polyglutamate transporter","volume":"63","author":"Volker L.","year":"2003","journal-title":"Cancer Res."},{"key":"e_1_2_7_25_2","first-page":"844","article-title":"Lack of correlation between pharamkokinetics and efficacy of low dose methotrexate in patients with rheumatoid arthritis","volume":"22","author":"Lafforgue P.","year":"1995","journal-title":"J. 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