Medical Q&As

Rheumatoid arthritis - methotrexate?

I have been suffering from rheumatoid arthritis for over a year and my doctor feels it may be worthwhile trying methotrexate. I am not sure about trying this drug, as I believe the side effects can be very severe. What can you tell me about the safety of this drug?

Methotrexate is a powerful drug and is a very effective agent in controlling rheumatoid arthritis. It is not a painkiller and belongs to a category of drugs known as immunosupressants. Since rheumatoid arthritis is an autoimmune disease it is very logical to treat the disease with a drug that acts directly on the immune system. The term autoimmune means that the immune system of the body is turned inwards against the body itself rather than the usual stance of responding to a threat from outside the body. An immunosuppressant alters the negative potential of the autoimmune process. The potential side effects of methotrexate are well documented but it is important to appreciate that side effects are not inevitable. Not everybody on this drug develops side effects. However, people undergoing treatment undergo regular monitoring of their blood. Particular attention is paid to the blood count and the white blood cell count in particular. If the white cell count falls below a certain level the drug dosage is reduced or stopped altogether. Liver and kidney function are also monitored in order to detect any adverse effects in relation to those organs. As with any powerful drug it is important to strike a balance between potential benefits and the risk of side effects. It is also important to consider that if a drug such as methotrexate is not used the risk exists that the arthritis could progress which could result in significant damage to the joints. Rheumatoid arthritis can be a very aggressive disease in some cases. It is very reasonable to use this drug subject to the routine blood monitoring taking place. Once the monitoring is in place and treatment protocols are followed the drug can be used safely. In other words we know it has the potential of causing side effects and that is the reason why regular monitoring is put in place.