Conclusion
toxicity, cytopenia, rheumatoid arthritis, psoriasis
RHEUMATOID ARTHRITIS, CYTOPENIA, PSORIASIS
This study did not find any significant difference in mortality or hematological recovery between 15 (standard) or 25 mg IV q6h (higher) leucovorin in severe toxicity associated with low-dose MTX. As expected, most patients had either rheumatoid arthritis or psoriasis who had inadvertently taken methotrexate daily instead of weekly. This condition was found to have high mortality (in both groups), explained in part by the inclusion of sick patients (severe cytopenia) at baseline.This is the first study to the best of our knowledge which has compared two different doses of leucovorin in low-dose MTX toxicity. This study suggests that there is no benefit of a higher dose over the standard dose of 15 mg leucovorin every 6 h. Based on this study no comments can be made of the adequacy of lower doses than 15 mg every 6 h. The high mortality in this study emphasizes the need for further research of other therapies and physicians should make sure they emphasize its unique dosing while prescribing methotrexate to patients and the consequences of inadvertent daily intake.