Methotrexate

Generic Name
Methotrexate
Brand Names
Metoject, Nordimet, Otrexup, Rasuvo, Reditrex, Trexall, Xatmep, Jylamvo
Drug Type
Small Molecule
Chemical Formula
C20H22N8O5
CAS Number
59-05-2
Unique Ingredient Identifier
YL5FZ2Y5U1
Background

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.

Indication

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.

Associated Conditions
Acute Lymphoblastic Leukemia (ALL), Acute Promyelocytic Leukemia, Bladder Cancer, Breast Cancer, Central Nervous System Lymphoma, Crohn's Disease (CD), Dermatomyositis (DM), Extrauterine Pregnancy, Gestational Trophoblastic Neoplasia, Graft-versus-host Disease (GVHD), Meningeal leukemia, Multiple Sclerosis, Mycosis Fungoides (MF), Non-Hodgkin's Lymphoma (NHL), Non-Hodgkin's Lymphoma, Relapsed, Osteosarcoma, Polyarticular Juvenile Idiopathic Arthritis, Polymyositis, Rheumatoid Arthritis, Soft Tissue Sarcoma, Squamous Cell Carcinoma of the Head and Neck (SCCHN), Systemic Lupus Erythematosus, Uveitis, Nonleukemic meningeal cancer, Refractory Non-Hodgkin's lymphoma, Refractory Takayasu arteritis, Severe Psoriasis
Associated Therapies
Medically induced abortion

Pembrolizumab and Combination Chemotherapy Before Surgery for the Treatment of Muscle-Invasive Bladder Cancer

First Posted Date
2020-05-12
Last Posted Date
2024-06-27
Lead Sponsor
University of Washington
Target Recruit Count
17
Registration Number
NCT04383743
Locations
🇺🇸

Fred Hutch/University of Washington Cancer Consortium, Seattle, Washington, United States

Surgery Alone Versus Methotrexate Before Surgery in Cesarean Scar Pregnancy

Phase 4
Conditions
Interventions
First Posted Date
2020-05-07
Last Posted Date
2020-05-07
Lead Sponsor
Mansoura University
Target Recruit Count
56
Registration Number
NCT04379219
Locations
🇪🇬

Mansoura University, Mansoura, Dakahliya, Egypt

Effect of Two Methotrexate in Sync With the First Adalimumab to Prevent the Immunisation Anti Ada in Spondyloarthritis

Not Applicable
Completed
Conditions
Interventions
First Posted Date
2020-04-24
Last Posted Date
2023-10-04
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Target Recruit Count
124
Registration Number
NCT04360785
Locations
🇫🇷

CH Pontoise, Pontoise, France

🇫🇷

CHR Orléans, Orléans, France

🇫🇷

Hopital Pellegrin, Bordeaux, France

and more 14 locations

Efficacy and Safety of Durvalumab in Non-Small Cell Lung Cancer With Leptomeningeal Metastasis

First Posted Date
2020-04-22
Last Posted Date
2020-05-27
Lead Sponsor
Hui Bu
Target Recruit Count
30
Registration Number
NCT04356222

Efficacy and Safety of MTX-loaded Nanoparticles to Treat Severe COVID-19 Patients

Phase 1
Conditions
Interventions
First Posted Date
2020-04-20
Last Posted Date
2020-04-29
Lead Sponsor
Azidus Brasil
Target Recruit Count
42
Registration Number
NCT04352465
Locations
🇧🇷

Prevent Senior Private Operadora de Saúde LTDA., São Paulo, Brazil

Blinatumomab and Tyrosine Kinase Inhibitor Therapy in People With Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia

First Posted Date
2020-04-01
Last Posted Date
2024-07-24
Lead Sponsor
Memorial Sloan Kettering Cancer Center
Target Recruit Count
17
Registration Number
NCT04329325
Locations
🇺🇸

Mount Sinai Hospital, New York, New York, United States

🇺🇸

Memorial Sloan Kettering Cancer Center, New York, New York, United States

Comparing Post-Transplant Cyclophosphamide as GVHD Prophylaxis to Standard of Care for Acute Leukemia Patients

First Posted Date
2020-03-19
Last Posted Date
2023-10-05
Lead Sponsor
King Faisal Specialist Hospital & Research Center
Target Recruit Count
264
Registration Number
NCT04314219
Locations
🇸🇦

King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

Effectiveness of Methotrexate Versus Prednisolone as First-line Therapy for Pulmonary Sarcoidosis

Phase 4
Active, not recruiting
Conditions
Interventions
First Posted Date
2020-03-19
Last Posted Date
2024-03-12
Lead Sponsor
Erasmus Medical Center
Target Recruit Count
138
Registration Number
NCT04314193
Locations
🇳🇱

Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, Netherlands

🇳🇱

Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands

🇳🇱

Isala Klinieken, Zwolle, Netherlands

and more 15 locations

A Study Assessing the Efficacy and Safety of SM03 in Patients With Active Rheumatoid Arthritis Receiving MTX

First Posted Date
2020-03-18
Last Posted Date
2021-01-08
Lead Sponsor
SinoMab BioScience Ltd
Target Recruit Count
510
Registration Number
NCT04312815
Locations
🇨🇳

Peking Union Medical College Hostipal, Beijing, China

Effects of Tofacitinib vs Methotrexate on Rheumatoid Arthritis Interstitial Lung Disease

First Posted Date
2020-03-17
Last Posted Date
2024-05-23
Lead Sponsor
Vastra Gotaland Region
Target Recruit Count
3
Registration Number
NCT04311567
Locations
🇸🇪

Karolinska University Hospital, Department of Rheumatology, Stockholm, Sweden

🇸🇪

Skåne University Hospital, Department of Rheumatology, Lund, Skåne, Sweden

🇸🇪

Clinical Rheumatology Research Center, The Sahlgrenska University Hospital, Göteborg, Västra Götaland, Sweden

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