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Methotrexate

Methotrexate (MTX) is a folate antagonist and one of the most widely used agents in both oncology and immunology.

Where the papers sit

23 papers from the last 6 months study methotrexate directly · updated from PubMed 12 Oct 2026

  • Rheumatoid Arthritis and Toxicity

    Methotrexate research is linking rheumatoid arthritis benefit to macrophage polarization, STAT3/NF-κB signaling and redox-sensitive synovial delivery. Combination strategies with cannabidiol and engineered peptide conjugates aim to improve local efficacy. Protective studies target oxidative stress, NRF2, ferroptosis and tissue injury in salivary glands, testes and heart. Renal failure remains a major safety concern, underscored by fatal conventional-dose intoxication.

    8 papers · 34.8%

  • Drug Delivery and Immune Effects

    Controlled-release hydrogels, nanogels and albumin nanoparticles are being developed to improve methotrexate delivery and redox activity. Immune-focused work examines TNF-α, immunogenicity and glucocorticoid combinations in inflammatory disease. Other studies address electrochemical detection and therapeutic vulnerability in glioma. The cluster has no single biological or clinical direction beyond expanding methotrexate applications.

    7 papers · 30.4%

  • Leukemia Delivery and Mucositis

    Oral cryotherapy and photobiomodulation are being evaluated to reduce methotrexate-associated oral mucositis and preserve quality of life in children with acute lymphoblastic leukemia. Precision delivery approaches target the blood-brain barrier and combine methotrexate with curcumin for leukemia treatment. Endocytosis and local or oral administration recur as delivery themes. A bullous pemphigoid mortality study falls outside this subject, making the cluster heterogeneous.

    5 papers · 21.7%

  • CNS Prophylaxis in Lymphoma

    High-dose methotrexate is being tested and refined for preventing central nervous system relapse in high-risk diffuse large B-cell lymphoma. Randomized and international multicenter studies focus on CNS relapse, overall response and treatment toxicity, especially neutropenia. Primary CNS lymphoma regimens combine methotrexate with rituximab and thiotepa. The open question is which patients benefit enough from prophylaxis to justify its toxicity.

    3 papers · 13%

PARADIGM SHIFT

Methotrexate CNS prophylaxis does not reliably prevent CNS relapse in high-risk large B-cell lymphoma

The international multicenter analysis of high-dose methotrexate CNS prophylaxis in ultra-high-risk large B-cell lymphoma found no significant difference in three-year CNS relapse between patients who did and did not receive prophylaxis, while the randomized phase 3 trial of intravenous versus intrathecal methotrexate prophylaxis in diffuse large B-cell lymphoma documented CNS relapses despite methotrexate exposure. Together, these independent studies undermine the assumption that methotrexate prophylaxis reliably prevents CNS relapse in high-risk disease and shift attention toward whether the strategy provides meaningful benefit at all, rather than which methotrexate route is preferable 42274647Jun 42062177Apr.

NEW DIRECTION

Methotrexate can act as a redox-dependent regulator of neutrophil fate and metabolism

The ex-vivo study of methotrexate effects on neutrophils and neutrophil–dendritic cell transdifferentiation found that methotrexate potentiated oxidative-stress-mediated transdifferentiation and metabolic reprogramming in a pro-oxidant setting, rather than merely serving as an anti-inflammatory or cytotoxic treatment. This assigns methotrexate a distinct role as a context-dependent modifier of immune-cell phenotype and bioenergetics, opening a mechanistic direction centered on neutrophil plasticity 42479252Jul.

methotrexate chemical structure

Papers

The 23 papers from the last 6 months that study methotrexate directly, newest first, by theme and by study type. Study types come from PubMed publication types and MeSH headings.

By theme

Rheumatoid Arthritis and Toxicity (8)
  1. PMID 41955700
  2. Therapeutic effects of Rosmarinus officinalis against methotrexate-induced submandibular salivary gland injury in male albino rats. Journal of molecular histology · 15 Sept 2026 PMID 42742856
  3. Enhanced mitigation of diabetic myocardial injury in rats via modulating the adiponectin/IRS-1/PI3K/p-AKT/FOXO-1 signaling by combining methotrexate and insulin. Molecular biology reports · 22 Aug 2026 PMID 42631883
  4. Fatal intoxication caused by conventional-dose methotrexate in an elderly patient with end-stage renal disease: A cautionary case report. Medicine · 22 Aug 2026 PMID 42629702
  5. Protective effects of icariin-loaded nanoliposomes against methotrexate-induced testicular toxicity via modulation of NRF2/NF-κB and ferroptosis signaling. Reproductive toxicology (Elmsford, N.Y.) · 13 Aug 2026 PMID 42595098
  6. Methotrexate potentiates oxidative stress-mediated transdifferentiation and metabolic reprogramming of neutrophils. Journal of bioenergetics and biomembranes · 21 Jul 2026 PMID 42479252
  7. Precision Engineered Dissolving Microneedles Enable Green-Light Activated Chemo-Photodynamic Therapy for Psoriasis. ACS applied materials & interfaces · 13 May 2026 PMID 42126938
  8. Synovial Targeting and Redox-Triggered Release: A Dual Strategy in Peptide-Drug Conjugates for Rheumatoid Arthritis. Bioconjugate chemistry · 24 Apr 2026 PMID 42030082
Drug Delivery and Immune Effects (7)
  1. Methotrexate's effect on cells and adalimumab immunogenicity in axial spondyloarthritis: A mathematical study. PLoS computational biology · 21 Sept 2026 PMID 42766629
  2. H3K27M drives OPC stemness and intrathecal therapeutic vulnerability in brainstem glioma organoids. Cell stem cell · 16 Sept 2026 PMID 42748922
  3. Chitosan-PLGA biopolymeric nanogel as a platform for enhanced methotrexate delivery and redox-modulated anti-inflammatory activity. Bioorganic chemistry · 27 Aug 2026 PMID 42660045
  4. A highly sensitive electrochemical sensor based on poly(alizarin red)/gold nanoflowers/molybdenum disulfide composite for the detection of methotrexate. Analytical sciences : the international journal of the Japan Society for Analytical Chemistry · 21 Aug 2026 PMID 42627469
  5. Glucocorticoid monotherapy versus combination with methotrexate or tocilizumab in giant cell arteritis: efficacy and safety at 78 weeks in a retrospective cohort study. Medicina clinica · 28 Jun 2026 PMID 42365805
  6. Formulation and in-vitro characterization of okra mucilage-based controlled release hydrogels. Pakistan journal of pharmaceutical sciences · 9 Jun 2026 PMID 42262204
  7. Folate-targeted, ethylenediaminetetraacetic acid-embedded, methotrexate-loaded albumin nanoparticles: Molecular modeling, design optimization, and in vitro anticancer evaluation in breast cancer cells. International journal of biological macromolecules · 7 May 2026 PMID 42092653
Leukemia Delivery and Mucositis (5)
  1. Biohybrid M13 phage backpacks for active blood-brain barrier traversal and precision central nervous system leukemia treatment. Biomarker research · 17 Sept 2026 PMID 42750063
  2. Effectiveness of oral cryotherapy in preventing methotrexate-induced oral mucositis in pediatric patients with acute lymphoblastic leukemia: a randomized controlled trial. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 14 Aug 2026 PMID 42599331
  3. Impact of oral mucositis treated by photobiomodulation protocol on the quality of life of pediatric oncology patients with acute lymphoblastic leukemia. Lasers in medical science · 12 Jun 2026 PMID 42283739
  4. Increased Mortality in Patients with Bullous Pemphigoid: A Nationwide Population-based Cohort Study of 5,738 Patients in Sweden. Acta dermato-venereologica · 28 May 2026 PMID 42206441
  5. Biopolymeric nanocapsules exploiting the synergistic effects of methotrexate and curcumin co-delivery via oral or local administration for breast cancer therapy. Journal of pharmaceutical sciences · 18 Apr 2026 PMID 41999919
CNS Prophylaxis in Lymphoma (3)
  1. High-Dose Methotrexate as CNS Prophylaxis in Ultra High-Risk Large B-Cell Lymphoma: An International Multicenter Analysis. Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 11 Jun 2026 PMID 42274647
  2. The Efficacy and Toxicity of CNS Prophylaxis in Diffuse Large B-Cell Lymphoma (CLSG-CNS-01): A Randomized, Multicenter, Prospective Phase 3 Trial. Hematological oncology · 30 Apr 2026 PMID 42062177
  3. Efficacy and Safety Profile of a Rituximab, Methotrexate, and Thiotepa-Based Regimen in Newly Diagnosed Primary CNS Lymphoma. International journal of cancer · 18 Apr 2026 PMID 41999193

By study type

Clinical trials (2)
  1. Effectiveness of oral cryotherapy in preventing methotrexate-induced oral mucositis in pediatric patients with acute lymphoblastic leukemia: a randomized controlled trial. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 14 Aug 2026 PMID 42599331
  2. The Efficacy and Toxicity of CNS Prophylaxis in Diffuse Large B-Cell Lymphoma (CLSG-CNS-01): A Randomized, Multicenter, Prospective Phase 3 Trial. Hematological oncology · 30 Apr 2026 PMID 42062177
Observational studies and case reports (7)
  1. Population pharmacokinetic model of high-dose methotrexate in Malaysian adults with hematological malignancies. European journal of clinical pharmacology · 6 Oct 2026 PMID 42836986
  2. Fatal intoxication caused by conventional-dose methotrexate in an elderly patient with end-stage renal disease: A cautionary case report. Medicine · 22 Aug 2026 PMID 42629702
  3. Glucocorticoid monotherapy versus combination with methotrexate or tocilizumab in giant cell arteritis: efficacy and safety at 78 weeks in a retrospective cohort study. Medicina clinica · 28 Jun 2026 PMID 42365805
  4. Impact of oral mucositis treated by photobiomodulation protocol on the quality of life of pediatric oncology patients with acute lymphoblastic leukemia. Lasers in medical science · 12 Jun 2026 PMID 42283739
  5. High-Dose Methotrexate as CNS Prophylaxis in Ultra High-Risk Large B-Cell Lymphoma: An International Multicenter Analysis. Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 11 Jun 2026 PMID 42274647
  6. Increased Mortality in Patients with Bullous Pemphigoid: A Nationwide Population-based Cohort Study of 5,738 Patients in Sweden. Acta dermato-venereologica · 28 May 2026 PMID 42206441
  7. Efficacy and Safety Profile of a Rituximab, Methotrexate, and Thiotepa-Based Regimen in Newly Diagnosed Primary CNS Lymphoma. International journal of cancer · 18 Apr 2026 PMID 41999193
Human data, design not indexed (2)
  1. Methotrexate's effect on cells and adalimumab immunogenicity in axial spondyloarthritis: A mathematical study. PLoS computational biology · 21 Sept 2026 PMID 42766629
  2. Methotrexate potentiates oxidative stress-mediated transdifferentiation and metabolic reprogramming of neutrophils. Journal of bioenergetics and biomembranes · 21 Jul 2026 PMID 42479252
Preclinical: animal, cell and lab studies (10)
  1. Therapeutic effects of Rosmarinus officinalis against methotrexate-induced submandibular salivary gland injury in male albino rats. Journal of molecular histology · 15 Sept 2026 PMID 42742856
  2. Chitosan-PLGA biopolymeric nanogel as a platform for enhanced methotrexate delivery and redox-modulated anti-inflammatory activity. Bioorganic chemistry · 27 Aug 2026 PMID 42660045
  3. Enhanced mitigation of diabetic myocardial injury in rats via modulating the adiponectin/IRS-1/PI3K/p-AKT/FOXO-1 signaling by combining methotrexate and insulin. Molecular biology reports · 22 Aug 2026 PMID 42631883
  4. A highly sensitive electrochemical sensor based on poly(alizarin red)/gold nanoflowers/molybdenum disulfide composite for the detection of methotrexate. Analytical sciences : the international journal of the Japan Society for Analytical Chemistry · 21 Aug 2026 PMID 42627469
  5. Protective effects of icariin-loaded nanoliposomes against methotrexate-induced testicular toxicity via modulation of NRF2/NF-κB and ferroptosis signaling. Reproductive toxicology (Elmsford, N.Y.) · 13 Aug 2026 PMID 42595098
  6. Formulation and in-vitro characterization of okra mucilage-based controlled release hydrogels. Pakistan journal of pharmaceutical sciences · 9 Jun 2026 PMID 42262204
  7. Precision Engineered Dissolving Microneedles Enable Green-Light Activated Chemo-Photodynamic Therapy for Psoriasis. ACS applied materials & interfaces · 13 May 2026 PMID 42126938
  8. Folate-targeted, ethylenediaminetetraacetic acid-embedded, methotrexate-loaded albumin nanoparticles: Molecular modeling, design optimization, and in vitro anticancer evaluation in breast cancer cells. International journal of biological macromolecules · 7 May 2026 PMID 42092653
  9. Synovial Targeting and Redox-Triggered Release: A Dual Strategy in Peptide-Drug Conjugates for Rheumatoid Arthritis. Bioconjugate chemistry · 24 Apr 2026 PMID 42030082
  10. Biopolymeric nanocapsules exploiting the synergistic effects of methotrexate and curcumin co-delivery via oral or local administration for breast cancer therapy. Journal of pharmaceutical sciences · 18 Apr 2026 PMID 41999919
Unclassified: not yet indexed with MeSH (2)
  1. Biohybrid M13 phage backpacks for active blood-brain barrier traversal and precision central nervous system leukemia treatment. Biomarker research · 17 Sept 2026 PMID 42750063
  2. H3K27M drives OPC stemness and intrathecal therapeutic vulnerability in brainstem glioma organoids. Cell stem cell · 16 Sept 2026 PMID 42748922