Methotrexate is a folate derivative that inhibits several enzymes responsible for nucleotide synthesis. This inhibition leads to suppression of inflammation as well as prevention of cell division. Because of these effects, methotrexate is often used to treat inflammation caused by arthritis or to control cell division in neoplastic diseases such as breast cancer and non-Hodgkin's lymphoma.
Due to the toxic effects of methotrexate, it is indicated for treatment of some forms of arthritis and severe psoriasis only if first line treatment has failed or patients are intolerant of those treatments.
Methotrexate was granted FDA approval on 7 December 1953.
Methotrexate oral solution is indicated for pediatric acute lymphoblastic leukemia and pediatric polyarticular juvenile idiopathic arthritis. Methotrexate injections for subcutaneous use are indicated for severe active rheumatoid arthritis, polyarticular juvenile idiopathic arthritis and severe, recalcitrant, disabling psoriasis.
Other formulations are indicated to treat gestational choriocarcinoma, chorioadenoma destruens, hydatiform mole, breast cancer, epidermoid cancer of the head and neck, advanced mycosis fungoides, lung cancer, and advanced non-Hodgkin's lymphoma. It is also used in the maintenance of acute lymphocytic leukemia. Methotrexate is also given before treatment with leucovorin to prolong relapse-free survival following surgical removal of a tumour in non-metastatic osteosarcoma.
St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, United States
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
Massachusetts General Hospital Cancer Center, Boston, Massachusetts, United States
Johns Hopkins University/Sidney Kimmel Cancer Center, Baltimore, Maryland, United States
Rush University Medical Center, Chicago, Illinois, United States
Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States
Rebecca and John Moores UCSD Cancer Center, La Jolla, California, United States
Oregon Health & Science University Cancer Institute, Portland, Oregon, United States
Oregon Health & Science University Cancer Institute, Portland, Oregon, United States
Albert Einstein Comprehensive Cancer Center, Bronx, New York, United States
Veterans Affairs Medical Center - Palo Alto, Palo Alto, California, United States
Raritan Bay Medical Center, Perth Amboy, New Jersey, United States
Louisiana State University School of Medicine, Shreveport, Louisiana, United States
Children's Hospital of Columbus, Columbus, Ohio, United States
Ireland Cancer Center, Cleveland, Ohio, United States
Children's National Medical Center, Washington, District of Columbia, United States
Fred Hutchinson Cancer Research Center, Seattle, Washington, United States
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