Landmark papers on the discovery of methotrexate for the treatment of rheumatoid arthritis and other systemic inflammatory rheumatic diseases: a fascinating story.
This review highlights the story of how methotrexate (MTX), a drug discovered for the treatment of childhood leukemia, became the mainstay of treatment and the standard-of-care for rheumatoid arthritis (RA) and was also found useful for several additional related rheumatological diseases. As against several synthetic disease-modifying antirheumatic drugs (csDMARDs) for treating RA that were discovered serendipitously, the use of low-dose MTX (LD-MTX) was based on sound reasoning and astute observations made in the 1940s and 1950s. The difference between high-dose MTX (HD-MTX) used in the treatment of childhood leukaemia and other malignancies as against LD-MTX used in rheumatology is emphasized.
A&R Clinic for Arthritis and Rheumatism and Department of Rheumatology, ISIC Superspeciality Hospital, Vasant Kunj, New Delhi, India. anand_malaviya@yahoo.com.
Anand N
AN
Malaviya
D000818:Animals; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000266:history / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000266:history; D055808:Drug Discovery / Q000266:history; D049673:History, 20th Century; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects / Q000266:history / Q000627:therapeutic use*; D012219:Rheumatology / Q000266:history; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D018501:Antirheumatic Agents; D008727:Methotrexate
discovery; historical; landmark papers; low-dose methotrexate; rheumatoid arthritis