Methotrexate.
Last updated Friday, February 11, 2005
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About MethotrexateWhat is methotrexate? Methotrexate (Rheumatrex) is a medicine that is used to treat rheumatoid arthritis (RA), psoriatic arthritis, Reiter's syndrome, and other conditions.How long have doctors been prescribing methotrexate? First developed to treat certain types of cancer, methotrexate is
routinely used at higher doses as a cancer therapy and is now used at
much lower doses to treat rheumatic diseases, like rheumatoid
arthritis. Methotrexate has been studied for over 20 years in the
treatment of rheumatoid arthritis, and in 1988 was approved for this
use in adults by the U.S. Food and Drug Administration (FDA).How does methotrexate work? 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.
When is methotrexate usually prescribed? 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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