Anti-Cancer Drug Also Found to Be Useful in Treating Some Arthritics

A registered nurse was in so much pain from arthritis that she found it impossible to get out of bed some mornings, and the medication her doctor suggested was not helping.

Then Dr. Richard Bertken prescribed methotrexate, an anti-cancer drug introduced in the 1950s.

“Before, I was in so much pain that it was even an effort to dress at times,” said nurse Leota Jacobs, who retired because of her illness. “The methotrexate got me to where I was able to take care of myself.”

Bertken has been treating patients with the drug since 1978, and about 50 patients in his care take it.

“It’s not something that’s absolutely brand new, but this is one of the biggest programs in the United States for methotrexate,” he said.

Bertken prescribes the drug only when patients with rheumatoid or psoriatic arthritis have not responded to one of the standard treatments: gold injections or a penicillin derivative called penicillamine.

The drug’s use in cancer treatment led to the discovery that people who take methotrexate orally each day have a higher than normal incidence of cirrhosis of the liver.

Further study showed the incidence of liver disease was lower when the drug was injected monthly--the method used in the arthritis treatment, Bertken said.

As a precaution, patients receiving the drug undergo a liver biopsy after about two years to check for problems.

“Of the biopsies we’ve done so far, we’ve had no problems,” Bertken said.

Methotrexate works by slowing production of the genetic building block, DNA, and the body’s immune cells, which malfunction when arthritis is present.

“Now we have one more thing that we can use, and it works most of the time,” Bertken said.

Jacobs is grateful for the treatment.

“Now I’m enjoying life,” she said. “You can get awfully depressed when you’re in pain.”