Monday April 6 News & Updates

Arthritis Health - Friday 20 Mar 2020 News & Updates


Arthritis Health remains open with normal business hours.

New patient visits; procedures (injections and infusions) will continue to be seen in the office. Routine office visits will be done electronically and are covered by Medicare, Blue Cross-Blue Shield and Aetna.

If you need to reach Dr. Howard or Paige, please help us respond to you most efficiently by using our patient portal. Contact Michelle at checkout for a formal invitation to sign up for the Portal. She needs to send you one in order for you to sign up. She can be reached by calling her extension at the office or by contacting her at

These are challenging times and we appreciate your patience with us.

Know that we are here with you every step of the way.


The newest recommendation by the CDC on Friday is for all people to wear masks in public.

We will be wearing masks and will require all patients coming into the office to wear some type of mask. This may be a formal medically approved mask or any mouth and nasal barrier that you can don.

If you do not have a mask, you will not be permitted to enter Arthritis Health.

This is in addition to our screening of all people entering the office including a 4-question inquiry about your health and travels and the taking of your temperature ensuring you have a temperature of less the 99.6.


Low dose methotrexate has been the cornerstone treatment in many rheumatic diseases and is first line therapy in rheumatoid arthritis used by millions of patients worldwide. It is also used in other systemic rheumatic diseases such as psoriatic arthritis, dermatomyositis, and systemic lupus erythematosus. Additionally, it is often used as an agent allowing the reduction of steroids required to control many autoimmune disease, and therefore often referred to as a steroid sparing therapy.

Dosages for rheumatoid arthritis and systemic rheumatic diseases are typically 10-25 mg/week, much lower than for cancer. We have known for decades that the use of low dose methotrexate is associated with many toxicities but they have not been well studied. The frequency and extent of toxicities was recently well researched, placebo controlled trial published this March in the Annals of Internal Medicine.

The findings are reassuring as to the overall safety of low dose methotrexate but also reinforce the need for continued vigilance and surveillance to detect untoward effects. This includes continued self-observation and reporting by patients, monitoring of regular laboratories every quarter and periodic assessments by your health care provider.

What were the side effects and how often did they occur?
Here is listing of the percent of over 6000 patients studied for and average of nearly 2 years. Half were on placebo and half were on methotrexate.  Please remember, in reporting any side effect, it may not be related to the medication. The side effects were predetermined as any adverse event of interest.

The bottom line is that there is an increase of laboratory, GI, lung and non-melanoma skin cancers. There was no increase due to low dose methotrexate of adverse events from musculoskeletal, neuropsychiatric, mucocutaneous, or all cancers other than non-melanoma skin cancers.

Methotrexate treated patients had fewer kidney related adverse events that placebo patients suggesting some protective effect.

The actual data is presented below.

Data is presented as % of patients having side effects and the hazard ratio is how many times is the increased risk over the placebo group.

Stay tuned for next Friday’s update. Be safe and be kind.

Your Staff at Arthritis Health

Please call us +1 (480) 609-4200 or contact us for more information.