Abstract
Methotrexate is currently the most widely used disease modifying drug for a variety of rheumatic diseases. It is most commonly used in rheumatoid arthritis, where it is still the first choice drug and the so-called "anchor drug" for combinations with other drug modifying drugs (DMARD) or biological agents, unless it is sufficiently effective in monotherapy.
It has a very favorable effect/risk ratio, as evidenced by the fact that after three years of treatment, more than 50 % of patients remain on therapy, which is twice as high as other DMARD. In addition to rheumatoid arthritis treatment, it has been successfully used to treat juvenile idiopathic arthritis and peripheral psoriatic arthritis.
Furthermore, it is administered in some manifestations of systemic connective tissue disorders such as systemic lupus erythematosus, systemic sclerosis, polymyositis/dermatomyositis, and others. This paper summarizes the most important general principles of methotrexate in patients with rheumatoid arthritis, its forms of administration, dosing, but also its risks associated with its frequent and long-term use.