Methotrexate: Use in the Post Dobbs v. Jackson Era.

Area of Science:

• Rheumatology
• Pharmacology
• Reproductive Health

Background:

• Methotrexate is a cornerstone medication for various rheumatic diseases, including rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus.
• Initially developed as chemotherapy, its efficacy in inflammatory conditions was recognized early on.
• Methotrexate also has abortifacient properties and is a known teratogen, posing risks during pregnancy.

Purpose of the Study:

• To examine the implications of recent US abortion policy changes on methotrexate use in rheumatology.
• To explore the impact of the Dobbs v. Jackson Women's Health Organization ruling on provider and patient perspectives regarding methotrexate.
• To highlight the evolving role of rheumatologists in addressing patients' sexual and reproductive health concerns.

Main Methods:

• Review of recent literature and data concerning methotrexate use in the context of reproductive health and policy changes.
• Analysis of provider perspectives and patient experiences post-Dobbs ruling.
• Discussion of the intersection of rheumatology, teratogenicity, and abortion policy.

Main Results:

• Recent data indicate that the Dobbs ruling has influenced both healthcare providers and patients concerning methotrexate.
• The teratogenic nature and historical use of methotrexate for abortion complicate its prescription and management.
• There is a growing need for rheumatologists to engage with patients on reproductive health matters.

Conclusions:

• The current landscape of abortion policy in the US presents unique challenges for methotrexate's clinical application.
• Rheumatologists are increasingly expected to navigate complex reproductive health discussions with patients on methotrexate.
• Further research and guidelines are needed to support rheumatologists in managing methotrexate therapy amidst evolving reproductive rights.