Dr. Wy, why the heck is my doctor telling me I should try chemotherapy for my arthritis? I don’t have cancer!!

Ask Dr. Wy…

Richard Wyderski, MD, FACP

Dr. Wy, why the heck is my doctor telling me I should try chemotherapy for my arthritis? I don’t have cancer!!

You’re describing an old drug called methotrexate (MTX) that IS used for certain cancers as well as an agent to suppress the immune system for autoimmune disorders such as lupus. When arthritis is due to an autoimmune disorder, it can leave the joints severely damaged. MTX helps prevent the joint destruction making it a “disease modifying drug” that does more than just improve pain symptoms.

We do know that osteoarthritis (OA) causes mild inflammation of the joints that usually doesn’t cause them to become swollen, red or warm, but over years can lead to a lot of cartilage damage and bone spurs. It’s the type of arthritis that many people have due to the wear and tear our joints suffer over time and can lead to chronic pain and disability.Over 50 million people in the US have it with the prevalence increasing with age costing tens of billions of dollars in expenses and lost wages. So it’s’ a big deal!

Two recent studies suggest that MTX might be a useful treatment to help reduce OA symptoms though they were short term studies. One demonstrated that people with hand osteoarthritis and joint inflammation proven by MRI scan had less pain and stiffness, and the other study demonstrated similar results for knee osteoarthritis

Is MTX right for you? As with all treatments, there are pros and cons and not all treatments are right for everyone. Talk to your doctor about whether getting an opinion from a rheumatologist that commonly prescribes MTX for arthritis would be right for you. 

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