Methotrexate

Eric Suhler, Kristin Biggee

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Methotrexate is a member of the antimetabolite drug class. Drugs in this classification, including methotrexate, azathioprine, mycophenolate mofetil, and leflunomide, exert anti-inflammatory activity via their effect on DNA synthesis, which suppresses proliferation of rapidly dividing cells, including leukocytes, as well as by other mechanisms which are incompletely understood. Methotrexate has the longest track record for safety and efficacy of all the antimetabolites both in children and in adults, and this, combined with its relatively low cost and the convenience of once-weekly administration, makes it the first-line steroid-sparing immunosuppressive for many ocular and systemic inflammatory diseases. Its use was first described in the 1940s for treatment of malignant diseases, but it was found shortly thereafter to be useful for inflammatory diseases, including rheumatoid arthritis, for which it gained FDA approval in 1988. Although methotrexate, like all other commercially available immunosuppressives as of this writing, is not FDA approved for the treatment of uveitis, it is FDA approved for two diseases associated with uveitis, psoriatic arthritis and juvenile idiopathic arthritis. The off-label use of methotrexate for uveitis was first reported in 1965 and has been commonly reported since, both as monotherapy and in combination with other immunosuppressives. A recent survey of practice patterns among uveitis specialists cited methotrexate as the most commonly prescribed initial corticosteroid-sparing agent for all anatomic locations of uveitis and the most preferred agent for anterior uveitis.

Original languageEnglish (US)
Title of host publicationIntraocular Inflammation
PublisherSpringer Berlin Heidelberg
Pages355-361
Number of pages7
ISBN (Print)9783540753872, 9783540753858
DOIs
StatePublished - Jan 1 2016

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Methotrexate
Uveitis
Immunosuppressive Agents
Antimetabolites
leflunomide
Mycophenolic Acid
Off-Label Use
Anterior Uveitis
Psoriatic Arthritis
Juvenile Arthritis
Azathioprine
Pharmaceutical Preparations
Rheumatoid Arthritis
Adrenal Cortex Hormones
Leukocytes
Anti-Inflammatory Agents
Steroids
Safety
Costs and Cost Analysis
DNA

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Suhler, E., & Biggee, K. (2016). Methotrexate. In Intraocular Inflammation (pp. 355-361). Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-540-75387-2_28

Methotrexate. / Suhler, Eric; Biggee, Kristin.

Intraocular Inflammation. Springer Berlin Heidelberg, 2016. p. 355-361.

Research output: Chapter in Book/Report/Conference proceedingChapter

Suhler, E & Biggee, K 2016, Methotrexate. in Intraocular Inflammation. Springer Berlin Heidelberg, pp. 355-361. https://doi.org/10.1007/978-3-540-75387-2_28
Suhler E, Biggee K. Methotrexate. In Intraocular Inflammation. Springer Berlin Heidelberg. 2016. p. 355-361 https://doi.org/10.1007/978-3-540-75387-2_28
Suhler, Eric ; Biggee, Kristin. / Methotrexate. Intraocular Inflammation. Springer Berlin Heidelberg, 2016. pp. 355-361
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