Low-Dose Methotrexate: A Mainstay in the Treatment of Rheumatoid Arthritis
Top Cited Papers
- 1 June 2005
- journal article
- review article
- Published by Elsevier in Pharmacological Reviews
- Vol. 57 (2) , 163-172
- https://doi.org/10.1124/pr.57.2.3
Abstract
Methotrexate administered weekly in low doses is a mainstay in the therapy of rheumatoid arthritis. Although originally developed as a folate antagonist for the treatment of cancer, its mechanism of action in the therapy of rheumatoid arthritis remains less clear. Several mechanisms have been proposed including inhibition of T cell proliferation via its effects on purine and pyrimidine metabolism, inhibition of transmethylation reactions required for the prevention of T cell cytotoxicity, interference with glutathione metabolism leading to alterations in recruitment of monocytes and other cells to the inflamed joint, and promotion of the release of the endogenous anti-inflammatory mediator adenosine. These mechanisms of action and the role of methotrexate in the suppression of rheumatoid arthritis are reviewed.Keywords
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