Aspirin is not associated with more toxicity than other nonsteroidal antiinflammatory drugs in patients with rheumatoid arthritis treated with methotrexate.

Abstract

To compare the clinical and laboratory toxicities of aspirin vs nonsteroidal antiinflammatory drugs (NSAID) in combination with low dose methotrexate (MTX). We retrospectively examined 34 patients with rheumatoid arthritis (RA) who completed 12 months of a prospective MTX trial. Analysis included descriptive and logistic regression. Twelve patients took an average of 4.5 g aspirin daily; 22 patients took other NSAID at stable doses. Limiting toxicity was not different between aspirin and NSAID treatment groups, respectively, for stomatitis (33 vs 27%), gastrointestinal symptoms (25 vs 18%), hepatic (25 vs 27%), or other toxicity. However, using logistic regression procedures, weight adjusted weekly MTX dose and prednisone dose correlated with toxicity. While toxicity is common when aspirin or NSAID are used with MTX to treat RA, there is no clinical difference between aspirin and NSAID with respect to that toxicity during 12 months of therapy.