KINGSTON RHEUMORS
Subcutaneous methotrexate
1. Methotrexate increasigly used
subcutaneously:
Methotrexate is increasingly being used s/c in patients who
fail due to inefficacy with oral methotrxate, or who are
intolerant, particularly at doses higher than 15mg weekly
Arthritis Rheum 2008;58:73-81.
Subcutaneous methotrexate produces a significantly
greater response in some patients with active rheumatoid
arthritis than does oral administration of the drug.
384 patients with active arthritis were randomized to
either oral methotrexate 15 mg/week, given as two 7.5
mg tablets plus a prefilled placebo syringe or to
subcutaneous methotrexate in a prefilled syringe
containing 10 mg/mL plus two placebo tablets for 24
weeks.
At week 16, patients who did not meet the American
College of Rheumatology criteria for 20% improvement
(ACR20) were switched from 15 mg to 20 mg oral
methotrexate, and from 15 mg to 20 mg subcutaneous
methotrexate for the remaining 8 weeks.
Seventy-eight percent of patients treated with
subcutaneous methotrexate had an ACR20 response
compared with 70% on oral methotrexate. An ACR70
response occurred in 41% of patients on subcutaneous and
33% of patients on oral methotrexate.
Patients with disease duration of at least 12 months had
higher ACR20 response rates, at 89% for subcutaneous and
63% for oral administration.
In the ACR20 non-responders, treatment was switched at
week 16. Switching from oral to subcutaneous
methotrexate resulted in an ACR20 response rate of 30%.
Switching from 15 mg to 20 mg of oral methotrexate
resulted in an ACR20 response rate of 23%.
Methotrexate is increasingly being used s/c in patients who
fail due to inefficacy with oral methotrxate, or who are
intolerant, particularly at doses higher than 15mg weekly
Arthritis Rheum 2008;58:73-81.
Subcutaneous methotrexate produces a significantly
greater response in some patients with active rheumatoid
arthritis than does oral administration of the drug.
384 patients with active arthritis were randomized to
either oral methotrexate 15 mg/week, given as two 7.5
mg tablets plus a prefilled placebo syringe or to
subcutaneous methotrexate in a prefilled syringe
containing 10 mg/mL plus two placebo tablets for 24
weeks.
At week 16, patients who did not meet the American
College of Rheumatology criteria for 20% improvement
(ACR20) were switched from 15 mg to 20 mg oral
methotrexate, and from 15 mg to 20 mg subcutaneous
methotrexate for the remaining 8 weeks.
Seventy-eight percent of patients treated with
subcutaneous methotrexate had an ACR20 response
compared with 70% on oral methotrexate. An ACR70
response occurred in 41% of patients on subcutaneous and
33% of patients on oral methotrexate.
Patients with disease duration of at least 12 months had
higher ACR20 response rates, at 89% for subcutaneous and
63% for oral administration.
In the ACR20 non-responders, treatment was switched at
week 16. Switching from oral to subcutaneous
methotrexate resulted in an ACR20 response rate of 30%.
Switching from 15 mg to 20 mg of oral methotrexate
resulted in an ACR20 response rate of 23%.