Methotrexate for Rheumatoid Arthritis – What is it, Treatment, Dosage, Effects and Risks.

For those diagnosed with RA or Rheumatoid Arthritis, Methotrexate has become a preferred choice of first-line treatment by doctors and health professionals. So, it’s only natural for a person to ponder over the effectiveness or safety aspects of Methotrexate treatment. With that in view, this article attempts to explore and explain facets about the disease as well as the drug from a layperson’s perspective. 

Rheumatoid Arthritis – Understanding The Disease A Little Better

Rheumatoid arthritis may be roughly defined as a disease of the joints, wherein the patient begins to feel pain, stiffness (mostly during the morning time), swelling and gradual impediment in functionality around the joints due to the formation of firm lumps beneath the skin, known as rheumatoid nodules.

However, RA isn’t degenerative (caused due to wear and tear) by nature like say, osteoarthritis. Instead, it is an autoimmune disorder meaning that your body’s defense mechanism (immune system) misinterprets specific component within the joints as foreign elements and attacks it.

RA is chronic (long lasting) and symmetric by nature in that the symptoms are experienced on either side of the body at the same time.

Then, there is the systemic aspect of RA, meaning that the entire body gets affected in one or more ways over time. As such, RA could well begin with the likes of muscle aches, tiredness, low fever etc before moving on to the joints, and later on include psychological offshoots such as depression.

Treatment Yes, Cure No

In spite of studies done over the years to understand the disease, there is still very little we know about RA. For instance, it’s very hard to pin-point RA prevalence since it doesn’t discriminate between race, ethnicity or age for that matter. Its more frequent in women than men. But, that too isn’t written in stone as even young adults, and older teenagers may get diagnosed with JRA (juvenile idiopathic arthritis).

In other words, no one knows for sure why one might get RA in the first place. As such, a patient diagnosed with RA cannot be cured of it. At best, he or she can receive treatments to suppress the immune system or slow down the progression of the disease. And this is where DAMRDs (Disease Modifying Anti-rheumatic Drugs) in general, and Methotrexate in particular comes into the picture.

Understanding DMARDs

DMARD or Disease Modifying Anti-Rheumatic Drug essentially works through suppressing the immune system and thereby reducing inflammation and swelling of the joints. These drugs are especially effective when administered during early stages of RA.

Now, it must be noted that using any medication that keeps your immune system in check can have its risks in that your body will no longer be able to fight off microbial infection as efficiently, but the gains outweigh the losses when seen from a wider perspective.

Methotrexate – From Cancer Fighter To Gold Standard In RA Treatment

Methotrexate is a commonly used medication for treating arthritis and other forms of rheumatic conditions. It falls in the DMARD category of drugs and approaches RA in a two pronged process. Its immediate task is to decrease the pain and swelling around the joints, but it’s also seen to arrest joint damage and disability when used over a longer term.

While it’s still unclear as to how exactly Methotrexate goes about reducing the severity associated with arthritis, this much can be said that it blocks certain types of enzymes (accelerants for biochemical reactions in the body) that are a part of the immune system.

What’s even more fascinating is that Methotrexate was never really meant to be a DMARD. Instead, its preliminary role was that of fighting cancer cells. It was only later during the 1980s when the drug began being used as an effective first-line treatment against RA.

Dosage And Time To Take Effect

Methotrexate can either be administered orally (pills) or intramuscularly (injections), usually on a weekly basis. Generally available in 2.5mg tablet form for oral consumption, adults diagnosed with RA usually begin with 3-4 pills taken once a week. In case of the latter, the same is injected under the skin just like one would do with insulin shots.

The initial improvements in arthritic pain and other conditions could be seen in as little as 3-6 weeks with full benefits becoming visible after 12 weeks. However, the actual effects may vary from one patient to the other.

Methotrexate – Advantages And Risks

There are three notable attributes of Methotrexate that make it a cornerstone in RA treatment. For starters, a number of RA patients show greater tolerance to Methotrexate as opposed to any other DMARD; so much so that there are records of patients taking it for up to five years without any untoward incident.

Furthermore, if Methotrexate failed for you the first time, it could always be reemployed at a later stage and still prove effective. And finally, Methotrexate combines well with other drugs in its class, and therefore forms an effective cog in combinational treatment of RA.

As with any medication, there are side-effects to using Methotrexate, less severe of them being fatigue, hair thinning, digestive disruption etc. Specifically, women who are expecting can be at greater risk to the drug and therefore should only take the drug after consulting a qualified doctor.

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