Ankylosing Spondylitis Research

This site summarizes the latest research in AS

• AS the facts
• A little history
• Spondyloarthropathies family
• Fatigue
• Osteoporosis
• Pregnancy and AS
• Related Conditions
  • Iritis
    Psoriasis
    Inflammatory bowel disease
    Rare complications
• Pain Management
  • Introduction to pain
    Self management of pain
• Medication
  • Anti-inflammatories
    Sulfasalazine
    Methotrexate
    Anti-TNF
• Alternative Medicines
• Genetics
• Expert opinion
  Prof. M Khan: diagnosis
• FAQ

Medication use in ankylosing spondylitis : Methotrexate

What is Methotrexate ?

Methotrexate is a disease-modifying agent (ie it affects the disease and inflammation process and not just the symptoms). It has been used with considerable success in treating people with Rheumatoid Arthritis and Psoriatic Arthritis but has limited effectiveness in managing Ankylosing spondylitis.

What does it do ?

Methotrexate is a drug which suppresses the immune system, and the exact mechanism of action is unclear.

There have not been any large studies looking at the effects of Methotrexate in the treatment of ankylosing spondylitis but only small studies and individual case reports. One of the earliest reports demonstrating the benefit of low-dose Methotrexate in AS was a small study done on 15 Turkish patients with AS which showed significant benefit without any marked side effects. Further studies using these low doses have shown to improve well-being and physical function in addition to reduction of ESR and CRP (markers of inflammation in the blood). All these studies have limited scientific relevance because they are performed on small numbers of people and are not well controlled trials.

How is it taken ?

Methotrexate is taken in either tablet form or as an injection, which could be taken intramuscularly (into the muscle), or subcutaneously (under the skin). It is taken once a week starting at 7.5 mg weekly and increased slowly to a maximum dose of 25 mg/week.

It is usually prescribe along with Folic Acid (an essential nutrient) one 5mg tablet once a week.

What are the side effects ?

The possible side effects seen with it being nausea, vomiting, diarrhea and a skin rash. It also could reduce the circulating blood cells, cause liver damage and lung fibrosis (shrinking of the lungs). Though the side effects appear quite daunting, research shows that more patients tend to remain on methotrexate on long-term basis than other disease-modifying agents (like Salazopyrin etc).

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