Methotrexate Compared With Chemotherapy

Linda Bradbury
Nurse Practitioner, Rheumatology, University of Queensland
President, Rheumatology Health Professionals Australia

Methotrexate is one of those disease-modifying agents that specialists will often use as a first line of treatment. It’s an excellent drug for managing patients with particularly rheumatoid arthritis and psoriatic arthritis.

Dr. Irwin Lim
Rheumatologist

Methotrexate is really our anchor drug in rheumatoid arthritis, so it’s the drug the vast majority of rheumatologists would like to use front up in treating rheumatoid arthritis. The problem is that methotrexate attracts a lot of bad press.

Linda Bradbury
Nurse Practitioner, Rheumatology, University of Queensland
President, Rheumatology Health Professionals Australia

There are various myths around that is about methotrexate. Methotrexate is used as an anti-cancer treatment but this is in much higher doses than the doses that we’re using for patients with arthritis. So although you will read out there and people will tell you that it’s a cancer drug, it’s really bad for you; actually the doses that we use in arthritis are much, much lower.

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

Sometimes it unfairly attracts a bad reputation. Part of that is due to the fact that methotrexate is also used for the treatment of some cancers but in a much, much higher dose than we use in rheumatology. So in fact when it’s used as a cancer chemotherapy drug, the way that it works in the body is completely different to the way that it works in rheumatology; where we use it at an extremely low dose. In fact, it’s a tablet that’s only taken once a week. When it’s taken weekly it’s very effective at treating rheumatoid arthritis. It often takes a few weeks for it to build up enough in the system to begin to work but once it’s begun to work, it often has very sustained effectiveness over a long period of time.

Dr. Irwin Lim
Rheumatologist

But when it’s used as chemotherapy it’s using grams by a drip in hospital. When we rheumatologists use methotrexate it’s typically at a standard dose of about 20 mg once a week by mouth. So in our hands the doses are very much lower and it’s clearly not chemotherapy.