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Methotrexate in TTT of rheumatoid arthritis
Methotrexate:• MOA: Is folic acid antagonist + cytotoxic +
immunosuppressant.• multiple IC enzymes → activation of ˉˉ ˉˉ
PMNLs, T-cells, and macrophages.• Is one of the first line drugs.• Used in >90% of RA cases.• One weekly.• Folic acid 5mg 24 hrs after methotrexate
dose to compensate for folic acid deficiency.
MOA of methotrexate (MTX):
S.E:1. Hepatotoxicity : common (monitor
LFTs),2. Myelosuppression (BMD),3. Teratogenicity.
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