New Zealand researchers have questioned the current methotrexate dosage for rheumatoid arthritis treatment. They say it is too slow to control onset of joint damage.
New Zealand researchers have questioned the current methotrexate dosage for rheumatoid arthritis treatment. They say it is too slow to control onset of joint damage.
Methotrexate is the most commonly used drug in the treatment of rheumatoid arthritis. However, the exact way in which it works is unclear.Scientists at the University of Otago, Christchurch measured the active forms of methotrexate in blood cells in patients starting and stopping treatment and found that it takes much longer than initially thought for the drug to reach steady blood levels.
“Certainly our research raises some serious questions about current methotrexate dosing regimens when starting the drug,” explains rheumatologist Dr Lisa Stamp. “At this stage it looks as though larger doses, more rapid dose escalation, or possibly administration by injection under the skin may lead to more rapid accumulation in the blood and potentially earlier disease control”.
Approximately 1 per cent of New Zealanders suffer from rheumatoid arthritis, many of whom are in constant pain and even crippled by the disease because of joint damage. Methotrexate is normally taken orally and binds to and inhibits several important enzymes, playing a role in a number of inflammatory pathways and thus limiting or controlling joint inflammation and subsequent damage.
Dosing normally starts at low levels, based on ‘response to treatment’, with increasing amounts until the disease is controlled. But valuable time may be lost with this method, resulting in unnecessary joint damage.
“One of the reasons why application of methotrexate has been based on ‘response to treatment’ is that there are a number of possible side-effects from this drug including nausea. However injecting under the skin may get around this problem,” says Dr Stamp.
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Methotrexate
This medication is an antimetabolite, curative in choriocarcinoma (cancer of the tissue that normally would develop into placenta). It is also used in other cancers like blood, breast and lung cancers. It is also used to suppress immunity in conditions such as psoriasis and rheumatoid arthritis.
This medication is an antimetabolite, curative in choriocarcinoma (cancer of the tissue that normally would develop into placenta). It is also used in other cancers like blood, breast and lung cancers. It is also used to suppress immunity in conditions such as psoriasis and rheumatoid arthritis.
The researchers conclude that it may be necessary to consider either injecting the drug or rapidly increasing oral doses, in order to reach optimum stable levels much earlier, to improve the beneficial effects on joint damage.
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Source-Medindia
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