TY - JOUR T1 - The Unintended Consequence of the Overturn of Roe v Wade: Restrictions on Methotrexate Use JF - The Journal of Rheumatology JO - J Rheumatol SP - 1284 LP - 1285 DO - 10.3899/jrheum.220782 VL - 49 IS - 11 AU - Bonnie L. Bermas Y1 - 2022/11/01 UR - http://www.jrheum.org/content/49/11/1284.abstract N2 - The recent Dobbs v Jackson Women’s Health Organization decision by the US Supreme Court not only limits reproductive options for our rheumatology patients but also has the unintended consequence of limiting treatment choices. Due to its embryotoxic potential, methotrexate (MTX), one of our most effective and heavily prescribed disease-modifying antirheumatic drugs, has come under scrutiny.In 1985, Weinblatt et al published the results of their landmark clinical trial demonstrating the efficacy of low-dose MTX for the treatment of rheumatoid arthritis (RA).1 Since then, MTX has become the mainstay of therapy for RA and inflammatory arthritis. It is also an important tool in the treatment of other rheumatologic conditions such as systemic lupus erythematosus (SLE) and vasculitis. The most recent American College of Rheumatology guideline for the management of RA recommends MTX as the first-line medication for this disorder.2 In the US, as in most other countries, demonstration of MTX failure in patients with inflammatory arthritis is required prior to approving coverage for biologics and small molecules.In addition to its use in rheumatic diseases, MTX provides a safe medical alternative to … ER -