Chassagne P, Levesque H, Moore N
Service de Rhumatologie, CHU Rouen, Bois Guillaume.
Therapie. 1990 Nov-Dec;45(6):499-504.
Methotrexate (MTX) is used increasingly for the treatment of rheumatoid arthritis (RA). It is an antagonist of folic acid. For the low doses used in RA (less than 15 mg/week), MTX is completely and rapidly absorbed with an active process membrane transport. The frequent toxic effects of this drug (hepatotoxicity, hematologic or possible long-term oncogenicity) limit its widespread use. MTX is as effective in treating RA as the other second line drugs and always more rapidly effective, perhaps because of anti-inflammatory properties. MTX must at the present time be used only in severe RA, refractory to more than one classical slow acting drug. Despite this, it is an extremely promising new agent in the therapy of rheumatic diseases.
甲氨蝶呤（MTX）越来越多地用于治疗类风湿性关节炎（RA）。它是叶酸拮抗剂。对于RA中使用的低剂量（每周小于15毫克），MTX通过主动过程膜转运被完全且快速吸收。该药物频繁的毒性作用（肝毒性、血液学毒性或可能的长期致癌性）限制了其广泛应用。MTX在治疗RA方面与其他二线药物一样有效，而且总是起效更快，这可能是由于其抗炎特性。目前，MTX仅用于对一种以上传统慢作用药物难治的重度RA。尽管如此，它仍是治疗风湿性疾病极有前景的新药。
