Beneficial Effects of Methotrexate?

[cythemia]

I have a read a little about methotrexate having some beneficial effects on Polycythemia and as I suffer from psoriatic arthritis and psoriasis I am being offered this for the management of these two conditions. Is there any study or trial running to test this as I also suffer from Polycythemia?

[piggie50]

Hi cythemia,

I also have PV , 13 years now. I also suffer from Rhumatoid Arthritis, 25 years. I take Hydroxicarbamide for my PV. The last two months I have had a huge flare up with my RA. I saw the rheumatologist 3 weeks ago. I am now on a 12 week course of steroids to reduce the inflammation. My rheumatologist is in conversation with my haematologist regarding starting Methotrexate. I asked the rheumatologist about the research done by Sheffield University regarding Methotrexate as a Jac2 inhibitor. He didn’t know anything about it but did advise that Jac2 inhibition is used for rheumatoid. He didn’t know what doses etc would be required regarding the PV. There was hoped to be a trial 2018 but I have heard nothing more about it. I am due a consultation with my heam next week, so will ask him then.

The link has been posted on here before by mhos61. Sorry I cannot seem to paste the correct link?

All very interesting.

Best wishes

Judy

[Tico in reply to piggie50]

Hi judy,so sorry to hear you've had a bad flare up of Rheumatoid Arthritis for the last couple of months as having 2 friends with it

I know it can be very debilitating and painful. They both also take Methotrexate and say it as helped to relieve the condition,I was surprised to learn off one of my friends it is actually a Chemotherapy drug, and to keep alcohol to a minimum because the Methotrxate can rarely cause side effects to the liver and to avoid caffeine as it can reverse the anti-inflammatory benefits of the drug but I'm sure you will discuss this with your consultant. Hope your feeling better soon. Regards,tina🤗

[piggie50 in reply to Tico]

Hi Tico,

Thank you for your response.

I am not particularly worried about taking the Methotrexate in itself. I used to take Pennicillamine many years ago which is also a DMARD like Methotrexate. The worry is taking both MXT and Hydroxicarbamide. My heam has suggested maybe stopping the Hydroxy for a couple of weeks and then re-introducing it gradually. I will probably need weekly blood tests in the beginning. My rheumatologist has two patients who have been on both drugs for 10 years, so fingers crossed I will be ok.

I do enjoy the occasional drink but have decided to stop completely to give the drugs the best chance.

Best wishes

Judy

[mhos61]

Hi cythemia,

I have read a few articles about methotrexate as a potential treatment for MPNs. They’re all dated around 2017, and unfortunately, I haven’t been able to source any more recent updates. Maybe it’s still research in progress.

It would be amazing if methotrexate on its own could control both inflammatory arthritis and MPNs for anyone suffering from both conditions. It’s all about calming down the Jak stat pathway. There maybe conflict in determining a suitable dose for each individual condition. All the same, interesting stuff!

It will be interesting to see how Judy (post above) progresses with both conditions when she starts methotrexate.

I’ve posted an interesting link below.

bloodjournal.org/content/12...

[mhos61]

See if this works Judy.

sheffield.ac.uk/news/nr/blo...

[piggie50]

It does, thanks Mary 😀

I’d printed a couple off, but whatever I tried to paste didn’t work.

Thank you. Xx

[hunter5582]

It is a rough go when the conditions start to pile up. It is bad enough when my eczema flairs up along with the JAK2-PV symptoms. I know RA would be even worse. I think the emerging research on the role that the JAK2 mutation plays in the increased inflammatory cytokine load we often experience is promising. Dealing more directly with the JAK2 overactivation would certainly be a good thing.

You did not mention any of the meds you might be on for the PV. Methotrexate does have listed interactions with both hydroxyurea and aspirin. Interaction with NDAIDs is specifically listed in the Black Box warning for Methotrexate.

Hope you get some answers soon.

[Kimmy53]

Hi interesting to read what is written about methotrexate as I’m on it for psoriatic arthritis in my hands , I was on it before I was diagnosis with mpn , still waiting to hear which one I have , I did wonder if it cause this as I was fit and well before all my problems ( portal thrombosis and PE ‘s )

as I don’t know much about this condition and as I’m still learning about it only time will tell,