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Related Experiment Videos

Methotrexate osteopathy in rheumatic disease

S J Preston1, T Diamond, A Scott

  • 1Department of Rheumatology, Royal North Shore Hospital, St Leonards, Australia.

Annals of the Rheumatic Diseases
|August 1, 1993
PubMed
Summary

Low-dose methotrexate can cause bone problems, known as methotrexate osteopathy, in adults. Discontinuing the drug resolved symptoms and bone histology confirmed osteoblast inhibition.

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Area of Science:

  • Rheumatology
  • Bone Metabolism
  • Pharmacology

Background:

  • Methotrexate is a widely used disease-modifying antirheumatic drug (DMARD).
  • Osteopathy is a general term for bone disease.
  • Low-dose methotrexate is frequently prescribed for autoimmune conditions.

Observation:

  • Two adult patients on low-dose weekly methotrexate developed symptoms suggestive of bone disease.
  • Iliac crest biopsies were performed for histomorphometric analysis.
  • Patients presented with stress fractures.

Findings:

  • Methotrexate discontinuation led to symptom resolution.
  • Bone histology revealed osteoblast inhibition, consistent with methotrexate osteopathy.
  • The condition occurred despite low weekly methotrexate doses.

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Implications:

  • Prolonged low-dose methotrexate therapy may adversely affect bone health.
  • Post-menopausal women may be particularly susceptible to methotrexate-induced bone effects.
  • Further research is warranted to understand methotrexate's impact on bone metabolism.