Methotrexate - Safe Backbone for the Treatment of Rheumatoid Arthritis.

Marco Krasselt

Journal: Current rheumatology reviews 2025;21(2):169-181

PMID: 38982927

Abstract

Methotrexate (MTX) is the primarily used disease-modifying antirheumatic drug (DMARD) for the treatment of Rheumatoid Arthritis (RA). MTX is a safe agent, even when used for years - provided that treatment is regularly monitored and prescribers follow some simple rules, such as prescribing tablets of a single strength only. Proper patient education contributes greatly to safe treatment. The knowledge of important pharmacologic facts, possible interactions, and clinical warning signs also helps to prevent or recognize intoxications early. Therefore, this review addresses key aspects regarding the safety of MTX. In this respect, it includes adverse events, possible interactions with frequently used drugs and details on the rare but life-threatening intoxication, e.g., due to erroneous daily intake.

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Address: Department of Endocrinology, Nephrology and Rheumatology, Medical Clinic III, Leipzig University Medical Centre, Liebigstr. 20, Leipzig, 04103, Germany.

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