Hearing Not Preserved by Methotrexate
Background: The immune system sometimes makes a mistake and produces antibodies that react with the body's own tissues. These are autoantibodies. Some autoantibodies may be directed against the inner ear. If untreated, this may result in rapidly progressive loss of hearing in both ears, ending in deafness. There may also be vestibular symptoms such as vertigo and ataxia (wobbliness). Treatment is aggressive steroid therapy.
The Gist: A clinical trial was underway to see if the antimetabolite drug methotrexate could maintain the hearing of patients with autoimmune inner ear disease who had been successfully treated with the steroid prednisone. Methotrexate failed to maintain hearing. The trial was halted.
Comment: This was an excellent clinical trial and a good example of how negative results are valuable. Methotrexate is not an innocuous drug. The knowledge that methotrexate does not help in this disease will spare patients from being needlessly exposed to it.