Methotrexate is an alternative to azathioprine in neuromyelitis optica spectrum disorders with aquaporin-4 antibodies. Kitley J, Elsone L, George J, Waters P, Woodhall M, Vincent A, Jacob A, Leite M I, Palace J J Neurol Neurosurg Psychiatry. 2013 Mar 6. PMID: 23467418. Abstract CommentRecommendBookmarkWatch