This book provides multidisciplinary reviews of the mechanism of action and uses of methotrexate in the treatment of cancer, psoriasis, gynecologic and inflammatory diseases. The intended audience is composed of clinicians involved in the care of patients suffering from oncologic, gynecologic, rheumatic diseases as well as scientists involved in research into the pathogenesis and treatment of these diseases. This book is unique in that it provides a single, state-of-the-art source for information regarding the mechanism and use of methotrexate in many different areas of medicine.

Although surprising, it seems fitting that a drug developed at the dawn of the era of rational drug design and therapeutics, methotrexate, should remain in common use for the therapy of so many different kinds of illnesses. Moreover, methotrexate has completely revolutionized the way in which medicine is practiced in a number of speciality areas. First developed to treat malignancies, methotrexate is now commonly used to treat gynecological problems, inflammatory arthritis, skin disease and probably other ailments as well. This work is designed to give a broad overview of the history of methotrexate's development, its prior use and its current therapeutic uses. As discussed in Chapter I, aminopterin and methotrexate were designed to inhibit mammalian folate metabolism but the concept of folic acid antag onism was soon applied to the development of antibacterial and anti parasitic agents. Trimethoprim and sulfa drugs were among the first antibiotics developed and they also remain quite useful today for the treat ment of a variety of infections."