[Methotrexate toxicity. Myths and facts]

Area of Science:

• Rheumatology and Pharmacology

Background:

• Methotrexate (MTX) is a widely used disease-modifying antirheumatic drug (DMARD).
• Concerns regarding severe pulmonary, hepatic, or mutagenic side-effects have been raised.
• Comparative safety data with other DMARDs is crucial for clinical practice.

Purpose of the Study:

• To evaluate the safety profile of Methotrexate in rheumatic disease treatment.
• To address and clarify existing concerns about MTX's potential adverse effects.
• To confirm the long-term safety and tolerability of MTX.

Main Methods:

• Review of existing clinical data and safety studies on Methotrexate.
• Analysis of reported pulmonary, hepatic, and infectious side-effects.
• Assessment of mutagenic potential following long-term MTX application.

Main Results:

• Methotrexate demonstrates a favorable safety profile, even under strict standards.
• No confirmed cases of severe pulmonary or hepatic toxicity were observed.
• Infection risk is not significantly higher compared to other DMARDs.
• Long-term application did not reveal any mutagenic potential.

Conclusions:

• Methotrexate is a safe and well-tolerated treatment option for rheumatic diseases.
• Existing safety concerns regarding MTX are largely unsubstantiated.
• MTX is expected to remain a cornerstone of antirheumatic therapy due to its established safety and efficacy.