Methotrexate shows promise in treatment of blood cancer, finds study

Methotrexate is one of the mainstay drugs for the treatment of inflammatory arthritis. It is a very powerful suppressor of certain cell signaling pathways which is central to many inflammatory disorders such as Rheumatoid arthritis. Taking a lead from this unique feature of the drug, a study conducted by a team of scientists from University of Sheffield's, Royal Hallamshire Hospital, and Universities of Oxford and Cambridge has revealed that this simple arthritis drug can reduce symptoms in sufferers of polycythemia vera (PV) and essential thrombocythemia (ET) - types of blood cancer. The study recently appeared in the British Journal of Haematology.

Methotrexate has been used for around 40 years to treat inflammatory forms of arthritis, including rheumatoid arthritis (RA) psoriatic arthritis and juvenile idiopathic arthritis because it not only reduces pain and swelling, but it can actually slow joint damage and disease progression. That’s why methotrexate is known as a disease-modifying anti-rheumatic drug (DMARD).

JAK/STAT activity plays a central role in the development of inflammatory diseases including rheumatoid arthritis, Crohn's disease, and psoriasis. This pathway has been shown to be involved in polycythemia vera (PV) and essential thrombocythemia (ET) - types of blood cancers as well.

This recent study has suggested that diseases such as rheumatoid arthritis all feature inflammatory processes driven by JAK/STAT activity and the effectiveness of MTX in these inflammatory diseases may well be a consequence of its ability to dampen the JAK/STAT pathway.

Following are a few highlights of the study

• Study shows a simple arthritis drug can reduce symptoms in sufferers of polycythemia vera (PV) and essential thrombocythemia (ET) - types of blood cancer


• Both ET and PV affect 3,000 people a year in the UK and standard treatments provide little relief from symptoms


• Methotrexate (MTX) - commonly used to treat arthritis - significantly improved the symptoms for both ET and PV patients and may also reduce raised blood counts


• Findings suggest MTX could provide low cost, safe and effective relief for blood cancer sufferers

Although current treatments are usually able to control the increased blood counts, they provide little relief from sometimes debilitating symptoms that can often have a significant impact on the quality of life.

Building on previous Medical Research Council-funded work in the Zeidler lab that identified methotrexate as an inhibitor of the JAK/STAT signaling pathway, this study examined hospital records to identify existing ET and PV patients already taking methotrexate for other diseases.

"While we still need to undertake a clinical trial to validate these findings, our results are very encouraging and suggest that a simple drug that has been used for nearly 40 years to treat arthritis can provide significant relief to blood cancer sufferers." said the lead author of the study Dr Zeidler.

"Patients we tested showed pronounced improvement in symptoms, something conventional treatments have been unable to provide."

"Given the very low cost of MTX, this research could offer an effective therapy on a budget accessible to healthcare systems throughout the world - marking a potentially substantial clinical and health economic benefit," he adds

An 81-year-old PV patient based in California commented: "Methotrexate seemed to do a very nice job of controlling itching and night sweats. My subjective experience of MTX was of a PV holiday."

For more details, click on the link

https://doi.org/10.1111/bjh.16193