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Study Suggests RA Drug Methotrexate Works Best As Injection

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A new study has found that a drug used in rheumatoid arthritis (RA) treatment can be more effective when administered via injection rather than taken orally.

Methotrexate is sometimes prescribed to RA patients because it can limit inflammation, helping to reduce pain and swelling associated with the disease.

Researchers in Canada and the United States set out to determine the comparative effectiveness of oral versus subcutaneous methotrexate as initial therapy for patients with early rheumatoid arthritis.

They recruited 666 patients who had experienced symptoms for one year or less. Of those taking part, 417 received the oral therapy and 249 were given the drug subcutaneously, at a higher dose.

Results published in the Annals of the Rheumatic Diseases show that at one year, 77% of those treated orally had changed treatment, compared with only 49% of patients in the subcutaneous group. Subcutaneous methotrexate was associated with a lower rate of treatment failure and a reduced average score in terms of disease activity.

The researchers concluded: “Initial treatment with subcutaneous methotrexate was associated with lower rates of treatment changes, no difference in toxicity and some improvements in disease control versus oral methotrexate over the first year in patients with early rheumatoid arthritis.”

A spokesman for Arthritis Research UK welcomed the new study, which he said provides promising results for people with inflammatory arthritis who are being treated with methotrexate.

“This study suggests that using subcutaneous injections of methotrexate, as opposed to swallowing the drug, results in better outcomes for patients and less severe disease. Although more research is needed, this has the potential to be a simple and effective way to improve the lives of people with arthritis.”

http://ard.bmj.com/content/early/2015/05/15/annrheumdis-2014-206504.abstract

http://www.arthritisresearchuk.org/news/general-news/subcutaneous-methotrexate-can-offer-benefits-in-rheumatoid-arthritis-treatment.aspx

http://www.nhs.uk/medicine-guides/pages/MedicineOverview.aspx?condition=Rheumatoid%20arthritis&medicine=methotrexate