Introduction To Methotrexate

Dr. Samuel Whittle
Rheumatologist, The Queen Elizabeth Hospital, Adelaide

Probably the biggest breakthrough in rheumatology has been the development of the so-called disease-modifying drugs (DMARDs). So these are medications that don’t just treat the symptoms of rheumatoid arthritis like pain or stiffness but actually treat the disease itself; so they help to re-educate the immune system to no longer create the inflammation in the lining of the joints that leads to all the symptoms and signs of rheumatoid arthritis. So when these medications work, not only do they help people to feel better and for the symptoms to go away but ultimately they also prevent any ongoing damage to the joints.

Assoc. Professor Peter Youssef
Rheumatologist, Royal Prince Alfred Institute of Rheumatology and Orthopaedics, Sydney
Chair – Arthritis Australia Scientific Advisory Committee

Almost all patients will require a disease-modifying drug at the time of diagnosis of rheumatoid arthritis. Unless the disease is very mild patients will go on to methotrexate. Methotrexate is the most important drug in the management of rheumatoid arthritis in that the response to methotrexate determines what other treatments will be used. If patients respond well to methotrexate they will remain on this medication in the longer term. If the response is not good, other medications will be added.

Dr. Irwin Lim
Rheumatologist

Methotrexate is a disease-modifying anti-rheumatic drug. What this means is it’s a drug that tries to modify the immune system to calm it down, to try to reduce the attack on the joints and the body. So rheumatologists use methotrexate to try to suppress the inflammation and to prevent joint damage.

Dr. Mona Marabani
Rheumatologist
President, Australian Rheumatology Association

We hope that by starting these things early we will actually arrest or retard the progression of those inflammatory changes that cause the damage. So most people would go onto methotrexate quite early. It’s a drug that’s given usually by mouth once a week so it’s a little bit unusual, a little bit different to the usual treatment you would get. So you take that on a once-a-week basis and then would follow up usually the next day or on another day with some folic acid.

Dr. Samuel Whittle
Rheumatologist, The Queen Elizabeth Hospital, Adelaide

Methotrexate is a really important drug. It’s probably our most important disease-modifying drug for treatment of rheumatoid arthritis and we also use it a lot in psoriatic arthritis. It’s a disease-modifying drug so therefore when it’s effective it helps to treat the disease at its source. It helps to prevent damage to the joints, it helps to prevent progression of symptoms, it helps to prevent long term cardiovascular disease; it’s a really very effective medication.