The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature Review

IntroductionMethotrexate (MTX) is a key cytostatic and immunosuppressive drug widely used in oncology and autoimmune disease treatment. It acts as a folic acid antagonist, inhibiting DNA synthesis and cell division. This review explores new applications of MTX beyond its traditional role. MTX show...

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Main Authors: Tomasz Tamborski, Michalina Zagalska, Adam Jan Ząbek, Jakub Paweł Kuźniar, Marta Turek, Adam Grzebinoga, Julia Szlążek, Barbara Roguska, Magdalena Szostak, Emilia Gabriela Chrzanowska
Format: Article
Language:English
Published: Kazimierz Wielki University 2025-05-01
Series:Journal of Education, Health and Sport
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Online Access:https://apcz.umk.pl/JEHS/article/view/60052
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author Tomasz Tamborski
Michalina Zagalska
Adam Jan Ząbek
Jakub Paweł Kuźniar
Marta Turek
Adam Grzebinoga
Julia Szlążek
Barbara Roguska
Magdalena Szostak
Emilia Gabriela Chrzanowska
author_facet Tomasz Tamborski
Michalina Zagalska
Adam Jan Ząbek
Jakub Paweł Kuźniar
Marta Turek
Adam Grzebinoga
Julia Szlążek
Barbara Roguska
Magdalena Szostak
Emilia Gabriela Chrzanowska
author_sort Tomasz Tamborski
collection DOAJ
description IntroductionMethotrexate (MTX) is a key cytostatic and immunosuppressive drug widely used in oncology and autoimmune disease treatment. It acts as a folic acid antagonist, inhibiting DNA synthesis and cell division. This review explores new applications of MTX beyond its traditional role. MTX shows potential in treating neuromyelitis optica spectrum disorders (NMOSD) as an alternative when other immunosuppressants are ineffective. In ophthalmic diseases like non-infectious uveitis and scleritis, it reduces inflammation and corticosteroid dependence.  MTX is also used for unruptured ectopic pregnancy as a non-surgical option in select cases, with meta-analyses confirming its effectiveness, though resolution times may vary. Additionally, emerging evidence suggests MTX may help prevent cardiovascular diseases in patients with inflammatory conditions by improving atherosclerosis biomarkers. ObjectiveThis review aims to provide an overview of MTX’s expanding applications, pharmacological properties, and the importance of therapy monitoring. Current State of KnowledgeMTX is well-established in both low doses for autoimmune diseases like rheumatoid arthritis and high doses for chemotherapy. While effective, it has significant toxicity risks, particularly at high doses, necessitating therapeutic drug monitoring (TDM) to minimize adverse effects like nephrotoxicity and mucositis. MethodsThis review synthesizes data from review articles, original studies, meta-analyses, and clinical guidelines, covering MTX’s mechanisms, pharmacokinetics, clinical applications, toxicity management, and TDM role. ConclusionsMTX remains a cornerstone in disease treatment due to its broad pharmacological spectrum. Effective therapy requires proper dosing, toxicity management, and monitoring strategies. Ongoing research seeks to optimize MTX use while minimizing risks.
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spelling doaj-art-dea943e4132f466081782824bf28ebf22025-08-20T03:53:21ZengKazimierz Wielki UniversityJournal of Education, Health and Sport2391-83062025-05-018010.12775/JEHS.2025.80.60052The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature ReviewTomasz Tamborski0https://orcid.org/0009-0003-6275-1010Michalina Zagalska1https://orcid.org/0009-0002-7312-0065Adam Jan Ząbek2https://orcid.org/0009-0003-6799-1814Jakub Paweł Kuźniar3https://orcid.org/0009-0002-6716-7502Marta Turek 4https://orcid.org/0009-0005-7713-6875Adam Grzebinoga 5https://orcid.org/0009-0001-5983-7564Julia Szlążek 6https://orcid.org/0009-0007-6977-8856Barbara Roguska7https://orcid.org/0009-0006-6905-7517Magdalena Szostak8https://orcid.org/0009-0003-9736-9823Emilia Gabriela Chrzanowska 9https://orcid.org/0009-0001-6228-1878County Hospital in Zawiercie, Miodowa street 14, 42-400Independent Public Clinical Hospital named Andrzej Mielęcki of the Silesian Medical University in Katowice, Francuska 20-24 Street, 40-027 KatowiceKatowice Oncology Center, ul. Raciborska 26, 40-074 Katowice. The Provincial Hospital in Bielsko-Biała Al. Armii Krajowej 101 43-316 Bielsko Biała. Independent Public Clinical Hospital named Andrzej Mielęcki of the Silesian Medical University in Katowice, Francuska 20-24 Street, 40-027 KatowiceUniversity Clinical Center of Prof. K. Gibiński of the Silesian Medical University in Katowice, Medyków 14 Street, 40-752 Katowice. Medical University of Silesia, 18 Medyków Street 40-752 KatowiceMedical University of Silesia, 18 Medyków Street 40-752 KatowiceHospital of the Ministry of Internal Affairs and Administration in Krakow, Kronikarza Galla 25 Street , 30-053 KrakówMedical University of Silesia, 18 Medyków Street 40-752 KatowiceIntroductionMethotrexate (MTX) is a key cytostatic and immunosuppressive drug widely used in oncology and autoimmune disease treatment. It acts as a folic acid antagonist, inhibiting DNA synthesis and cell division. This review explores new applications of MTX beyond its traditional role. MTX shows potential in treating neuromyelitis optica spectrum disorders (NMOSD) as an alternative when other immunosuppressants are ineffective. In ophthalmic diseases like non-infectious uveitis and scleritis, it reduces inflammation and corticosteroid dependence.  MTX is also used for unruptured ectopic pregnancy as a non-surgical option in select cases, with meta-analyses confirming its effectiveness, though resolution times may vary. Additionally, emerging evidence suggests MTX may help prevent cardiovascular diseases in patients with inflammatory conditions by improving atherosclerosis biomarkers. ObjectiveThis review aims to provide an overview of MTX’s expanding applications, pharmacological properties, and the importance of therapy monitoring. Current State of KnowledgeMTX is well-established in both low doses for autoimmune diseases like rheumatoid arthritis and high doses for chemotherapy. While effective, it has significant toxicity risks, particularly at high doses, necessitating therapeutic drug monitoring (TDM) to minimize adverse effects like nephrotoxicity and mucositis. MethodsThis review synthesizes data from review articles, original studies, meta-analyses, and clinical guidelines, covering MTX’s mechanisms, pharmacokinetics, clinical applications, toxicity management, and TDM role. ConclusionsMTX remains a cornerstone in disease treatment due to its broad pharmacological spectrum. Effective therapy requires proper dosing, toxicity management, and monitoring strategies. Ongoing research seeks to optimize MTX use while minimizing risks. https://apcz.umk.pl/JEHS/article/view/60052methotrexateapplicationsautoimmune diseasesneurological disordersocular inflammationectopic pregnancy
spellingShingle Tomasz Tamborski
Michalina Zagalska
Adam Jan Ząbek
Jakub Paweł Kuźniar
Marta Turek
Adam Grzebinoga
Julia Szlążek
Barbara Roguska
Magdalena Szostak
Emilia Gabriela Chrzanowska
The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature Review
Journal of Education, Health and Sport
methotrexate
applications
autoimmune diseases
neurological disorders
ocular inflammation
ectopic pregnancy
title The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature Review
title_full The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature Review
title_fullStr The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature Review
title_full_unstemmed The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature Review
title_short The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature Review
title_sort evolution of methotrexate applications a multidimensional approach to treating various disorders a literature review
topic methotrexate
applications
autoimmune diseases
neurological disorders
ocular inflammation
ectopic pregnancy
url https://apcz.umk.pl/JEHS/article/view/60052
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