Methotrexate for RA: 5 Reasons It’s Still the Gold Standard

Introduction to Methotrexate 0:00

If I could only prescribe one medication for rheumatoid arthritis for the rest of my career, it would be methotrexate. Not a biologic. And I'm not alone. Most rheumeatologists around the globe agree with this. But here is the thing. most of my patients are terrified of methotrexate. They google it, they see this as a chemotherapy drug, and they want to run away from metho trexite and go to the others. Today, I'm going to give you five evidence-based reasons why rheumatologists trust methtrextate more than any other rheuma-tertardise medication and why understanding these reasons could change your feeling about methotrexate.

Before we start, I want to know, were you nervous when your doctor first mentioned metho trexite? Drop a yes or no in the comments below. I bet I know the answers. And by the end of this video, i think you will see this medication in a completely different way. Let me start with a story of one of the patient. She is 42 and a school teacher, a mom of two. She was diagnosed with rheumatoid arthritis three years ago. Her hands were so swollen she could not even button her kids clothes. her knees ache all the time so badly she couldn't stand in front of the classroom.

A rheometologist prescribed her methotrexate. she was scared as always. He read online that it was a toxic chemotherapy drug.

Patient Story and Treatment Results 1:35

she almost did not feel the prescription but finally she trusted her doctor she started methotrexate within three months her swelling was gone within six months she was back to full-time teaching her passionate thing to do today Three years later, her RA is still in good control. Her x-rays show no signs of any joint damage. And she takes one pill once a week. This story is not unusual. It's actually the norm for many patients who give methotrexate a real chance. And this isn't just my opinion. It's backed by over 50 years of research and hundreds of clinical trials involving more than 37,000 patients.

So you can see the math. Up to 40% of the patients who have rheumatoid arthritis have major improvement of their disease activity with methotrexat alone. When combined with a short course of steroids, almost half of the patients achieve low disease activity or remission. With the right treatment strategy, over 75 to 80 percent of RA patients can reach their treatment goal with methotrexate. Let me give you an example. Lets think of rheumatoid arthritis like a fire in your joints. Your immune system is a Fire.

Methotrexit is like fire extinguisher. It does not just mask the smoke like pin pill does. It actually puts out the fire. It calms down your overactive immune system, so it stops attacking your joints. And here is what happens.

Reason 1: Controls RA and Protects Joints 3:30

it is What it makes so special. Methotrexate does not just make your joint feel better, it actually changes the course of your rheumatoid arthritis journey. Research shows it slows down joint damage that doctors cannot see on the x-rays. That means it's protecting your Joints for the future. not just treating today's pain. If you did not know that methotrexate could actually protect your joints from joint damage, hit that thumbs up. This is the kind of information that changed how you think about your treatment in rheumatoid arthritis.

Now, let's go to reason number two, the reason why methotrexid is a good drug in rheumatoid arthritis. And here is something most patients don't know. Methotrexit makes almost every other rheuma arthritis medication work better. So it's a great team player. Think of methotrexate like a point guard on a basketball team. A pointguard does not always score the most points, but they make everyone else on the team better. That's exactly what methtrexit does. All these biologic medications such as adalumumab or humira, enbrel or etanercept, remicate or orencia, work together when combined with methotrexate.

That's why we call methtetrexit a team player. Patients on biologics plus methetrexic stay on their medication longer. This is why even when patients need to add a biologic, rheumatologists almost always keep methodrextate on board. It is the foundation that makes everything else work better. methotrexid is a team player in managing rheumatoid arthritis. Let's say metotrexit alone gets you to 40% better adding a biologic on top of metho trexit might get you up to 80% but if you take the same biologics with

Reason 2: Improves Other RA Medications 5:20

our meto trexit you might only get upto 70% and methtreixit is the secret ingredient in how we manage rheuptoide arthritis This is why both the American College of Rheumatology and the European League against rheumaticism also recommend combining biologics with methotrexac whenever possible, whenever you are able to tolerate the methotrexic. Now the number 3 reason why most rheumatologists like methotrexate is it may protect your heart. This is the reason that surprises most patients. Did you know that people with rheometoarthritis have a higher risk of heart attacks and stroke?

RA isn't just a joint disease. The inflammation affects your whole body including your blood vessels. But here is a good news. Research shows that Methotrexate may actually lower your risk of heart problems. A landmark study of over 1,200 rheumatoid arthritis patients found that methotrexit users had a 60% lower risk for dying, and the biggest benefit was a 70% reduction in cardiovascular death. Another study of almost 200,000 RA patients confirmed that methotrexid reduces the cardiovascular risk by almost 20 percent.

So it can actually help prevent your heart attack risk. And another last study, over 18, 000 patients found that methotrexit was also associated with 18% lower risk of cardiovascular disease. So summing up all of those studies together, it tells us that methotrexid actually helps lower down your mortality. That's why it's a very powerful drug to help you live longer, not just manage your rheumatoid arthritis.

Reason 3: May Lower Heart Risk 7:10

That's why we have a win-win. Methotrexate treats your joints and may also protect your heart and increase your longevity. It is like getting two treatments from one medication. Now, I want to be transparent here. Cardiovascular benefit appears to come from controlling inflammation of rheumatoid arthritis, not from methotrexit itself acting as a hard rock. That's why it's not recommended as a primary drug to help prevent your cardiovascular risk for other patients who don't have rheumatoid arthritis.

So in rheuma arthritis, because of inflammation, your risk of heart disease is higher. That is how methotrexid helps lower that risk. It is not applicable to other people who do not have it. Now the reason number four why we all like methtetrexit is it is affordable and accessible. Let's talk about something that matters in real world, the cost of the drug. And you can see, methotrexate cost up to $20 to 50 per month. In comparison, biologic medication costs up $6,000 per months, and Jack inhibitors almost $3,500 per year.

This is not a typo. Methotrexit costs almost 100 times less than a biologics. Here's the thing. For many patients, methotrexate works just as well. Many studies have suggested that metotrexit in combination with other drugs such as sulfasalazine and hydroxychloroquine can cause as much disease control as compared to biologics. That's why not every RA patient needs to be on biologic. We can manage your rheumatoid arthritis at the lower cost and same type of benefit using methotrexate and combination therapy.

That's why we always don't need to go to expensive drug to control your Rheumataid Arthritis. And you might ask why this matters? RA is a lifelong disease. You may need treatment for decades. A medication that is affordable means you have less stress about your insurance coverage, less worry about prior authorizations,

Reason 4: Affordable and Accessible 9:20

and less financial burden on your family and yourself and available in almost every part of the world. Whether you are watching this video here in the U.S. or in India or Nepal or anywhere else, you will have access to methotrexate. This is why metotrexit is the great equalizer. Whether your live in New York or New Delhi, You have to access this medication. And the number 5th reason and a very powerful reason that we love methoxet, it may help you live longer. this is a reason which gives me chills as a rheumatologist.

Methotrexate does not just improve your quality of life, it may actually help you live longer. And for this, let me use strong evidence. A landmark prospective study where they look at patients with rheumatoid arthritis and they follow for long term, the RA patient on methotrexit had 60% lower risk of death. compared to those not on methotrexate. And this survival benefit was seen in all causes of death, including cardiovascular disease and even death from lung disease too. That's why it is a very good drug.

Think of metotrexit as a shield. It is not just protecting your joints, it's protecting you heart and your life. You might ask the question, why does this happen? uncontrolled rheumatoid arthritis inflammation does not just destroy your joints, it damages the blood vessels, increases the risk of heart attack, and also shorten your life. By controlling that inflammation early and effectively, Methotrexid addresses the root cause of these problems. No other conventional DMR has shown this survival benefit.

That's why methotrexit is unique. Now I know many of you who are listening to this video, you might be thinking, But doctor, it is a chemotherapy drug.

Reason 5: May Improve Survival 11:20

How can it be safe? Let me clear this myth once and for all. In cancer treatment, the dose of methotrexate typically used is from 100 milligram to 1000 milligram per week. It is given in multiple times per The goal is to kill rapidly dividing cancer cells. And compare this with rheumatoid arthritis, the dose is 7.5 to 25 mg per week, given once per day, with the goal to calm down your overactive immune system. The dose makes the poison. At the low dose we use for rheumatoid arthritis, methotrexid is not a chemotherapy.

It is an immune system regulator and with proper monitoring, regular blood test, folic acid supplementation, it has an excellent safety profile. Fewer than 5% of the patients have to stop methtrexit because of serious side effects. Compare that to 100% of the patients who will have progression of joint damage if their RA is not well controlled. So you can do the math. Now let me recap the 5 reasons why rheumatologists trust methotrexate in managing rheuropathitis. 1. It works. up to 40% major improvement alone with methotrexate, even more in combination.

2. It is the ultimate team player. it makes biologics and other medications work better. 3. Protect your heart. up to 20% reduction in cardiovascular disease, 20 percent reduction your heart attack risk. 4. It is affordable, it is almost 100 times cheaper than biologics, and it's widely available throughout the globe. And number five, it may help you live longer from 41 to 60 percent reduction in overall mortality in rheumatoid arthritis patients. No other R.A. medication checks all those boxes.

That's why methotrexate has been the gold standard for over 50 years and why it's not going anywhere soon. Now, here is your action checklist. and screenshot this or download it from the link in the description below.

Safety, Dosing, and Final Takeaways 13:40

Here is the action checklist that you can use today on how you effectively use methotrexate. If you have been prescribed methtrexit, give it a real chance. It takes up to 6 to 12 weeks for it to be fully effective, so have some patience. Always take your folic acid with methodrextate, it reduces your side effects. Take it once a week, not every day. and put some alarm in your phone to remind you of methotrexate. And keep all your blood test appointments. They are your safety net to prevent side effects.

If you have any side-effects, don't just quit. Talk to your doctor about the solution first. Don't believe everything you read online. Trust your rheumatologist. And remember, methotrexate protect your joint, your heart, and possibly your life. Now, remember our patient Maria from the beginning? She almost did not feel that prescription. She always let fear win, but she trusted the science. she Trusted her doctors. And today she's living proof that metotrexit can transform lives. now your turn. Which of these five reasons surprised you the most?

Drop in the comment below. And if this video changed how you feel about methotrexate, share it with someone who has just been diagnosed with RA and was handed over the methtrexit. They need to hear this. Thank you so much for watching. If you have not yet subscribed, subscribe to our channel and then share this with somebody whom you love. I'll see you in my next video. Bye bye.