Effect of Disease Modifying Agent on Oxidant and Antioxidant Status in Rheumatoid Arthritis

Background: Rheumatoid Arthritis is a chronic disease and a leading cause of disability in people with advancing age. Disease modifying antirheumatic drugs have become the mainstay of management in rheumatoid arthritis. Among these drugs, methotrexate the most frequently used agent has a proven anti-inflammatory action and is known to slow down the progression of the disease. Hence the present study is undertaken to evaluate the effect of methotrexate on the oxidant and antioxidant status in patients with rheumatoid arthritis on methotrexate.Methods: A total of 40 rheumatoid arthritis patients and 40 controls were enrolled for the study. The rheumatoid arthritis patients were further divided into patients on methotrexate (group I) and patients without methotrexate (group II). The lipid peroxidation index -Malondialdehyde and total antioxidant activity, superoxide dismutase and glutathione levels were analyzed in all the participants.Results: A significant increase in total antioxidant activity (p = 0.048) and decrease in lipid peroxidation (p = 0.04) was found in methotrexate treated arthritis patients compared to patients without methotrexate. A significant negative correlation (p=0.01) was found between MDA and total antioxidant activity in both groups of patients whereas, the antioxidant enzyme superoxide dismutase was positively correlated with lipid peroxide levels. Conclusion: In conclusion low dose methotrexate seems to act as an effective anti-inflammatory drug and may also play an important role in minimizing the oxidative stress in rheumatoid arthritis. Serum total antioxidant activity is significantly raised in subjects with altered liver function profile.