Renal clearance and intracellular half-life essentially determine methotrexate toxicity: A case series

Abstract

Methotrexate (MTX) is an antirheumatic drug used worldwide in many indications of chronic inflammation and autoimmunity including psoriasis.1 In principle, it is safe if monitored carefully and has major cost-effective therapeutic benefits.2 Major adverse events for MTX are related to the folate antagonism and primarily affect highly proliferative tissues such as bone marrow and gastrointestinal mucosa.3 Life-threatening myelosuppression leading to sepsis with potential fatal outcome is the most serious complication of MTX treatment that may occur despite regular dose administration.