Current place of metotrexate in treating rheumatoid arthritis

Metotrexate (MTX) is currently the most commonly used disease-modifying drug for rheumatoid arthritis. Rheumatoid arthritis (RA)

is an inflammatory autoimmune disease characterized by erosive synovitis that ultimately results in joint destruction and disability

of the patient. Early diagnosis and initiation of treatment with disease-modifying antirheumatic drugs (DMARDs) has a favourable effect

on the disease course. Metotrexate reduces the disease activity and slows down structural joint damage. It is used both as monotherapy

and in combination with other DMARDs or with biological drugs. In addition to RA treatment, MTX has been successfully used to treat

some manifestations of other systemic connective tissue diseases, such as psoriatic arthritis, systemic lupus erythematosus, systemic

scleroderma, poly/dermatomyositis, and others. This review article discusses the general principles of treatment with MTX, its routes

of administration, efficacy as well as toxicity in both short-term and long-term administration. The aim is to emphasize the important

role of MTX in treating rheumatoid arthritis, but also to highlight its possible adverse effects and other risks associated with its frequent

use, the detection and management of which can involve the pharmacist who thus can, along with the physician, contribute to increasing

treatment safety for patients.

Keywords: metotrexate, rheumatoid arthritis, disease-modifying drugs