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Journal of Education, Health and Sport

The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature Review
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  • The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature Review
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  4. Medical Sciences

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

Authors

  • Tomasz Tamborski County Hospital in Zawiercie, Miodowa street 14, 42-400 https://orcid.org/0009-0003-6275-1010
  • Michalina Zagalska Independent Public Clinical Hospital named Andrzej Mielęcki of the Silesian Medical University in Katowice, Francuska 20-24 Street, 40-027 Katowice https://orcid.org/0009-0002-7312-0065
  • Adam Jan Ząbek Katowice Oncology Center, ul. Raciborska 26, 40-074 Katowice. https://orcid.org/0009-0003-6799-1814
  • Jakub Paweł Kuźniar The Provincial Hospital in Bielsko-Biała Al. Armii Krajowej 101 43-316 Bielsko Biała. https://orcid.org/0009-0002-6716-7502
  • Marta Turek Independent Public Clinical Hospital named Andrzej Mielęcki of the Silesian Medical University in Katowice, Francuska 20-24 Street, 40-027 Katowice https://orcid.org/0009-0005-7713-6875
  • Adam Grzebinoga University Clinical Center of Prof. K. Gibiński of the Silesian Medical University in Katowice, Medyków 14 Street, 40-752 Katowice. https://orcid.org/0009-0001-5983-7564
  • Julia Szlążek Medical University of Silesia, 18 Medyków Street 40-752 Katowice https://orcid.org/0009-0007-6977-8856
  • Barbara Roguska Medical University of Silesia, 18 Medyków Street 40-752 Katowice https://orcid.org/0009-0006-6905-7517
  • Magdalena Szostak Hospital of the Ministry of Internal Affairs and Administration in Krakow, Kronikarza Galla 25 Street , 30-053 Kraków https://orcid.org/0009-0003-9736-9823
  • Emilia Gabriela Chrzanowska Medical University of Silesia, 18 Medyków Street 40-752 Katowice https://orcid.org/0009-0001-6228-1878

DOI:

https://doi.org/10.12775/JEHS.2025.80.60052

Keywords

methotrexate, applications, autoimmune diseases, neurological disorders, ocular inflammation, ectopic pregnancy, Cardiovascular Disease

Abstract

Introduction
Methotrexate (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.

Objective
This review aims to provide an overview of MTX’s expanding applications, pharmacological properties, and the importance of therapy monitoring.

Current State of Knowledge
MTX 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.

Methods
This 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.

Conclusions
MTX 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.

References

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Published

2025-05-10

How to Cite

1.
TAMBORSKI, Tomasz, ZAGALSKA, Michalina, ZĄBEK, Adam Jan, KUŹNIAR, Jakub Paweł, TUREK , Marta, GRZEBINOGA , Adam, SZLĄŻEK , Julia, ROGUSKA, Barbara, SZOSTAK, Magdalena and CHRZANOWSKA , Emilia Gabriela. The Evolution of Methotrexate Applications: A Multidimensional Approach to Treating Various Disorders – A Literature Review. Journal of Education, Health and Sport. Online. 10 May 2025. Vol. 80, p. 60052. [Accessed 17 June 2025]. DOI 10.12775/JEHS.2025.80.60052.
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Vol. 80 (2025)

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Medical Sciences

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Copyright (c) 2025 Tomasz Tamborski, Michalina Zagalska, Adam Jan Ząbek, Jakub Paweł Kuźniar, Marta Turek , Adam Grzebinoga , Julia Szlążek , Barbara Roguska, Magdalena Szostak, Emilia Gabriela Chrzanowska

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