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Last updated Friday, February 11, 2005
What is it?
History of methotrexate
How it works
This medicine acts by altering the body's use of folic acid (a vitamin), which is needed for cell growth. Scientists suspect that this interference with folic acid is an important reason for methotrexate's benefit in rheumatoid arthritis. Methotrexate belongs to a group of medicines that are called "second-line therapies" or "disease-modifying anti rheumatic drugs." These drugs may affect the activity of RA to a greater extent than commonly prescribed drugs, such as aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). Methotrexate is usually taken along with NSAIDs. It may begin to work as early as three to six weeks after beginning treatment.
Use cases
Methotrexate is used in both children and adults with active or progressive rheumatoid arthritis, although FDA approval is only for adults. It may be prescribed after trying one or more other second-line therapies such as antimalarials or gold salts. It also may be recommended even before starting these drugs. The decision to begin methotrexate will be based upon the opinions of both you and your doctor regarding the progression and activity of your disease. Methotrexate benefits a high percentage of those who use the drug. This improvement includes a decrease in the number of painful and swollen joints, as well as an overall reduction in RA disease activity. Patients with rheumatoid arthritis who do not respond to methotrexate often are good candidates for surgical reconstruction of their damaged joints, such as total hip arthroplasty, total knee arthroplasty, and total shoulder arthroplasty.
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