Related Experiment Video
Updated: Aug 5, 2025
04:50
Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
288
Methotrexate in generalized myasthenia gravis: a systematic review
Mario B Prado1,2,3, Karen Joy B Adiao4
1Department of Physiology, College of Medicine, University of the Philippines, Manila, Philippines.
Acta Neurologica Belgica
|March 26, 2023
Summary
Methotrexate may be a cost-effective alternative to azathioprine for managing myasthenia gravis (MG). This immunosuppressant shows potential for steroid-sparing benefits with rare adverse effects, particularly in developing nations.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Myasthenia gravis (MG) management often relies on azathioprine (AZA) as a first-line steroid-sparing agent.
- High AZA costs limit its use in developing countries, necessitating alternative treatments.
- Methotrexate (MTX) is a potential, more affordable immunosuppressant for MG.
Approach:
- A systematic literature search was conducted across Medline/Pubmed, Embase, and Cochrane databases.
- Eligibility criteria included generalized MG patients, MTX intervention, and outcomes of effectiveness, steroid-sparing efficacy, and adverse effects.
- Four studies (two clinical trials, one observational study) met the selection criteria.
Key Points:
- Two clinical trials and one observational study indicated MTX improved MG outcomes.
- Evidence on MTX's steroid-sparing efficacy is mixed; one trial found no benefit, while another suggested it surpasses AZA after 10 months.
- Adverse effects of MTX were infrequent, with non-specific pain and elevated transaminases being most common.
Conclusions:
- MTX demonstrates potential as a safe and effective steroid-sparing alternative to AZA for myasthenia gravis.
- Its affordability makes it a viable option, especially in resource-limited settings.
- Further research may clarify MTX's role in long-term MG management.
Related Concept Videos
01:20Myasthenia Gravis: Overview and Treatment
1.7K
Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
1.7K
01:15Myasthenia Gravis: Diagnostic Tests
1.1K
Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
1.1K
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
213
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
213
01:28Disorders of the Skeletal Muscle
1.0K
The clinical conditions affecting the skeletal muscle tissue are broadly categorized as musculoskeletal and neuromuscular disorders.
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
1.0K
01:31Skeletal Muscle Relaxants: Therapeutic Uses
535
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
535
01:21Rheumatic Heart Disease III: Medical Management
23
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
23