Methotrexate (MTX) has proven to be efficacious for controlling palindromic rheumatism (PR) in seropositive and seronegative patients over a median of 43 months of treatment.

• A total of 59 patients with diagnosis of PR and treatment with MTX for at least 6 months were included in this study.

• In 89.8% of cases, attacks were controlled, and remission was achieved in 80% of the patients during 12 months post-initiating therapy with MTX.

• In 20.3% of cases, treatment failure was experienced.

• The MTX treatment-failed group significantly more commonly exhibited wrist joint involvement and positive rheumatoid factor (RF).

• Evolution to rheumatoid arthritis was more common in RF positive patients vs in RF negative patients.

• Regarding remission rate and evolution to rheumatoid arthritis, there were no significant differences between anticitrullinated C peptide positive and negative patients.