Adverse Effect Profile With Low-Dose Methotrexate Therapy in Patients Suffering With Rheumatic Diseases

January 2023 in “ National journal of physiology, pharmacy and pharmacology ”

Vijaya Prasanna Parimi, Mehdi Ali Mirza, Rajiv Kumar Bandaru, Bhavana Surapareddy, Sudha Bala, Srigaari Rakesh

methotrexate hair loss folic acid cytopenia transaminitis autoimmune rheumatic diseases MTX folate

TLDR Low-dose methotrexate is generally safe but can cause mild to severe side effects, and folic acid can reduce these risks.

Low-dose methotrexate (MTX) is generally well tolerated in patients with autoimmune rheumatic diseases (AIRDs), though it can cause mild adverse effects such as hair loss (7.7%) and nausea (3.9%), and more severe effects like cytopenia (1.6%) and transaminitis (2.2%). A study of 815 patients, predominantly female (87%), found that those not taking folic acid had a higher incidence of adverse events (81.2%; P = 0.0001). Early identification of toxicities and folate supplementation can improve patient outcomes.

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