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Can methotrexate slow fracture healing?

Q) I have rheumatoid arthritis and osteoporosis. For the past 10 years I've been treated with 12.5g methotrexate weekly.

I fell last year and broke my femur, which has been pinned but is healing very slowly. Can methotrexate slow down the healing process?
Maureen, Cheshire (Spring 2015)

A) Higher doses of methotrexate have been shown to slow fracture healing, but the inflammation caused by rheumatoid arthritis also has a bearing on the risk of breaking bones and how well the they heal. So effective treatment with medication to control the inflammation of rheumatoid arthritis is important.

If you have osteoporosis and had a fracture you should have been offered treatment with bone-sparing drugs like bisphosphonates to reduce your risk of further fractures. This is something your GP or rheumatologist can advise you on.

This answer was provided by Dr Tom Margham for the Spring 2015 edition of our magazine, Arthritis Today, and was correct at the time of publication.

Send your questions for Dr Tom Margham to

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