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.
Louis A. Weiss Memorial Hospital, Chicago, Illinois, United States
Fort Wayne Medical Oncology and Hematology, Inc., Fort Wayne, Indiana, United States
University of Chicago Cancer Research Center, Chicago, Illinois, United States
All Children's Hospital, St. Petersburg, Florida, United States
Nemours Children's Clinic, Jacksonville, Florida, United States
San Jorge Children's Hospital, Santurce, Puerto Rico
Christie Hospital N.H.S. Trust, Manchester, England, United Kingdom
University of Texas - MD Anderson Cancer Center, Houston, Texas, United States
University of Texas - MD Anderson Cancer Center, Houston, Texas, United States
Universitair Ziekenhuis Antwerpen, Edegem, Belgium
Federico II University Medical School, Naples (Napoli), Italy
Ospedale S. Gennora USL 42, Naples (Napoli), Italy
Children's Oncology Group, Arcadia, California, United States
Children's Oncology Group, Arcadia, California, United States
Fred Hutchinson Cancer Research Center, Seattle, Washington, United States
Union Hospital Cancer Center at Union Hospital, Elkton MD, Maryland, United States
Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital, Pittsburgh, Pennsylvania, United States
Cancer Institute of New Jersey at the Cooper University Hospital - Voorhees, Voorhees, New Jersey, United States
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