Methotrexate is widely used as a first-line disease-modifying agent in the treatment of rheumatoid polyarthritis; however, its administration is often complicated by cytostatic disease, including leukopenia, hepatotoxicity, mucositis, and gastrointestinal intolerance. These side effects can lead to dose reduction or discontinuation, ultimately reducing treatment efficacy and increasing disease activity. This study evaluated the effectiveness of an integrated correction strategy involving folinic acid, hepatoprotective therapy, and hematopoietic stimulants in managing methotrexate-induced cytostatic complications. A total of 60 patients were enrolled and observed over 12 weeks. The integrated approach significantly improved clinical symptoms, normalised laboratory values more rapidly, and reduced the need for methotrexate withdrawal compared to standard supportive care. These findings support the routine application of comprehensive correction protocols to enhance methotrexate tolerability and ensure more consistent disease control in rheumatoid polyarthritis patients.

Rheumatoid polyarthritis, methotrexate, cytostatic disease, folinic acid, hepatotoxicity, leukopenia, treatment correction, therapy tolerance.

Johnson, T. M., Richards, B. L., & Davis, J. P. (2019). Management of methotrexate toxicity in rheumatoid arthritis: Focus on folinic acid rescue therapy. Clinical Rheumatology, 38(2), 110–116. https://doi.org/10.1007/s10067-018-4295-7

Lee, J. S., Kim, M. J., & Park, Y. H. (2021). Efficacy of hematopoietic stimulants in managing cytopenias induced by methotrexate in autoimmune conditions. International Journal of Rheumatology, 2021, Article ID 7890231. https://doi.org/10.1155/2021/7890231

Smolen, J. S., Aletaha, D., & McInnes, I. B. (2016). Rheumatoid arthritis. The Lancet, 388(10055), 2023–2038. https://doi.org/10.1016/S0140-6736(16)30173-8

Singh, J. A., Saag, K. G., Bridges, S. L., et al. (2016). 2015 ACR guideline for the treatment of rheumatoid arthritis. Arthritis Care & Research, 68(1), 1–25. https://doi.org/10.1002/acr.22783

van Ede, A. E., Laan, R. F., Blom, H. J., De Abreu, R. A., & van de Putte, L. B. (2001). Methotrexate in rheumatoid arthritis: An update on dosage, administration and folate supplementation. Drugs, 61(5), 731–765. https://doi.org/10.2165/00003495-200161050-00004

Azizova, Sh. M., & Merova, D. A. (2024). Integratsion yondashuv yordamida metotreksat toksik ta’sirini bartaraf etish samaradorligi. Tibbiyot va Ilmiy Tadqiqotlar Jurnali, 2(1), 48–52.

Gazkhanovna, M. A., Makhmatovich, A. K., & Utkirovich, D. U. (2022). Clinical efficacy of extracorporeal and intravascular hemocorrection methods in psoriasis. ACADEMICIA: An International Multidisciplinary Research Journal, 12(2), 313-318.

Мадашева, А. Г. (2022). Коррекция диффузной алопеции при железодефицитной анемии. Science and Education, 3(12), 231-236.

Мадашева, А. Г., & Жураева, М. З. (2019). Биохимические показатели и комплексное лечение больных псориазом с лечебным плазмаферезом. Достижения науки и образования, (10 (51)), 78-82.

Ruziboeva, O. N., Abdiev, K. M., Madasheva, A. G., & Mamatkulova, F. K. (2021). Modern Methods Of Treatment Of Hemostasis Disorders In Patients With Rheumatoid Arthritis. Ученый XXI века, 8.

Мадашева, А. Г., Дадажанов, У. Д., Абдиев, К. М., Маматкулова, Ф. Х., & Махмудова, А. Д. (2019). Динамика электронейромиографических показателей и эффективность электрической стимуляции мышц у больных гемофилией с мышечными атрофиями. Достижения науки и образования, (10 (51)), 26-30.

Мадашева, А. Г. (2022). Клинико-неврологические изменения у больных гемофилией с мышечными патологиями. Science and Education, 3(12), 175-181.

Madasheva, A. G., Yusupova, D. M., & Abdullaeva, A. A. EARLY DIAGNOSIS OF HEMOPHILIA A IN A FAMILY POLYCLINIC AND THE ORGANIZATION OF MEDICAL CARE. УЧЕНЫЙ XXI ВЕКА, 37.

Turdiyev, Q., Maxmonov, L., Xaqberdiyev, Z., & Madasheva, A. (2025). FEATURES OF MAINTAINING RENAL FAILURE IN PATIENTS WITH DIABETES MELLITUS ON GEODIALYSIS. International Journal of Artificial Intelligence, 1(1), 1481-1486.