Low-dose methotrexate in Rheumatology: A reinvented drug.

IF 1.1 Q2 MEDICINE, GENERAL & INTERNAL
Kushagra Gupta, Vinod Ravindran
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引用次数: 0

Abstract

Low-dose methotrexate (LD-MTX) is the anchor drug used in the treatment of various rheumatological illnesses. There are a lot of misconceptions associated with the long-term use of MTX in the minds of practitioners. The origin of most of these myths stems from the ill effects associated with high-dose MTX used in cancer chemotherapy. In this review, we have summarised and discussed the latest data regarding the safety of LD-MTX. The current evidence underscores the safety of LD-MTX. It is not associated with liver and lung fibrosis as previously thought. Other major concerns such as bone marrow suppression and increased risk of infection are rare with chronic LD-MTX therapy. Hypersensitivity pneumonitis is a rare acute lung toxicity associated with MTX intake, it does not cause interstitial lung disease and in fact, may be protective against it. There is a slight concern about the increased risk of skin malignancy associated with MTX intake; however, association with no other malignancy has been found. It has taken many decades for researchers to clear the various preconceptions associated with MTX. It is time for the academic community to embrace LD-MTX as a new, separate and reinvented drug.

低剂量甲氨蝶呤在风湿病学中的应用:一种重新发明的药物。
低剂量甲氨蝶呤(LD-MTX)是用于治疗各种风湿病的锚定药物。从业人员对长期使用甲氨蝶呤有很多误解。这些误解大多源于癌症化疗中使用大剂量甲氨蝶呤的不良影响。在这篇综述中,我们总结和讨论了有关LD-MTX安全性的最新数据。目前的证据强调了LD-MTX的安全性。它并不像以前认为的那样与肝和肺纤维化有关。其他主要问题,如骨髓抑制和感染风险增加,在慢性LD-MTX治疗中很少见。超敏性肺炎是一种罕见的与甲氨蝶呤摄入相关的急性肺毒性,它不会引起间质性肺疾病,事实上,可能对其有保护作用。对于与甲氨蝶呤摄入相关的皮肤恶性肿瘤风险的增加,有一点值得关注;然而,未发现与其他恶性肿瘤相关。研究人员花了几十年的时间来清除与甲氨蝶呤有关的各种先入之见。现在是学术界接受LD-MTX作为一种新的、独立的、重新发明的药物的时候了。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
81
审稿时长
20 weeks
期刊介绍: The Journal of the Royal College of Physicians of Edinburgh (JRCPE) is the College’s quarterly, peer-reviewed journal, with an international circulation of 8,000. It has three main emphases – clinical medicine, education and medical history. The online JRCPE provides full access to the contents of the print journal and has a number of additional features including advance online publication of recently accepted papers, an online archive, online-only papers, online symposia abstracts, and a series of topic-specific supplements, primarily based on the College’s consensus conferences.
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