In a nutshell
This study looked at the benefits of switching from an oral dose of methotrexate (Rheumatrex) to a subcutaneous (under the skin) injection. The authors concluded that the benefits of subcutaneous methotrexate include improved effectiveness at higher doses and few side effects.
Some background
Patients with rheumatoid arthritis (RA) often experience pain caused by inflammation in their joints. Methotrexate is one of the most commonly prescribed treatments for rheumatoid arthritis (RA). It can reduce inflammation and slow the progression of the condition. Methotrexate can be taken orally (by mouth) or by injection. Injections can be given intramuscularly (into a muscle) or subcutaneously (under the skin).
A prefilled auto-injector pen has recently been developed. This will allow patients to treat themselves with methotrexate at home in a painless and uncomplicated way. Some patients do not respond well to methotrexate taken orally at low doses and may need to increase their dosage or switch to another treatment. The auto-injector pen is suitable for administering high doses of the drug.
Methods & findings
The authors reviewed a number of studies to examine the safety and effectiveness of subcutaneous (SC) injections of methotrexate.
One study involving 384 RA patients on either oral or SC methotrexate concluded that, at higher doses, SC injections are more effective than oral doses. 41% of patients on SC methotrexate reported a significant improvement in their condition. 33% of the group on oral methotrexate reported the same improvement.
Another study included patients receiving oral or SC methotrexate at 10, 15, 20 or 25 mg per week. This study showed that for doses of 15 mg per week or more, SC injections of methotrexate were more effective than oral doses. Similar results were reported in a separate trial. A response rate of 70% or more was more common when 15 mg of methotrexate was administered via SC injection (41%) than by oral dose (33%).
Data collected from two different studies determined that side effects related to the stomach or intestines were similar across methods of administration. However, loss of appetite and nausea were more common with SC methotrexate.
The bottom line
The authors concluded that methotrexate administered by SC injection is more effective than oral administration at higher doses.
The fine print
The information in this report is collected from a number of different studies. Methods and treatment times varied between studies.
What’s next?
Consult with your physician to discuss your treatment options with methotrexate.
Published By :
Rheumatology International
Date :
Mar 02, 2016
Hello, i have been taking methotrexate tabs 15mgs for the past 6 month for my bad eczema, my skin has improved a lot since but im feeling so tired and low. My bloods has been monitored and all normal and i take folic acid weekly, is there any vitamins or any other medication i can take? I’m getting fed up now and this tiredness is avoiding me from going to keep fit classes dance etc… Thank you
You may need more folic acid.
I’m on metho for 9 months, I was taking 1 mg folic acid daily, but 3 moths ago that was increased to 5mg daily. I feel better for it. I also take vit. supplements B12 and D everyday.
I have RA and have been taking Laflunomide as my main drug; however, recently I have come down with prurigo nodularis (PA) and a form of squamous cancer or possible keratoacanthomas type. I want my doctors to put me on methotrexate instead of laflunomide. I am basing this decision through knowledge gained by reading studies by Jaad research.I would appreciate any added information I can get from you regarding the change.
Good morning, have tried methotrexate for maybe four months, my stomach was upset ALL the time, fluish symptoms. Was put on Enbryl, it was GREAT ! Felt good, joints were better……then I retired, now no carrier will pick up the huge bill on this drug ! Have been without anything for a couple yrs and am considering methotrexate injections, will I run into the same stomach issues and cost ?
Thx, Jim