Tuesday, 12 Nov 2019

You are here

Parenteral Out-Performs Oral Weekly Methotrexate

A systematic review in PLOS suggests that parenteral MTX therapy is more successful than oral MTX in achieving optimal disease activity control. 

A meta-analysis to compare the efficacy of oral versus parenteral MTX in RA used the ACR20 response at 6 mos as the primary endpoint.  Out of a search result of 357 papers, they found only 4 studies that met inclusion criteria; this included a total of 703 patients randomized to either treatment. MTX dosing started at 15mg/week and was increased up to 25mg/week.

The odds of achieving ACR20 was higher using parenteral (vs. oral) with an OR = 3.02 (95% CI 1.41, 6.46). Those on parenteral MTX had a 20% greater odds of attaining ACR20 improvement (95% CI 5.0%, 35.3%) compared to those on oral MTX.

Overall there were no significant differences in adverse events between groups.

The authors propose more widespread use of parenteral MTX to better control of disease and decrease the demand for biologic agents.

The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Mallinckrodt Receives SEC Subpoena

Reuters reports that Mallinckrodt Plc has received a subpoena from the U.S. Securities and Exchange Commission for documents related to the drugmaker’s lawsuit against the U.S. Department of Health and Human Services (HHS).

ACR Responds to CY2020 Medicare Physician Fee Schedule Proposed Rule

Rheumatology leaders commend CMS for proposing E/M code changes and urge agency to make additional changes to final rule.d

ACR Survey Shows Half of Patients Cannot Afford Treatments

Americans living with rheumatic disease face significant healthcare challenges, according to a national patient survey released this week by the American College of Rheumatology. More than 1,500 U.S. adults living with rheumatic disease responded to the survey, which asked a range of questions related to healthcare access, affordability and lifestyle. Key findings include that even though 90 percent of respondents reported having health insurance coverage, nearly 60 percent said they had difficulty affording their medications or treatments in the past year.

Medical Use of Cannabis in 2019

JAMA has published an overview of cannabis and its medical uses. Although nearly 10% of cannabis users in the United States report using it for medicinal purposes, there is insufficient evidence to support the use of medical cannabis for most conditions for which its use is advocated or advised. Nevertheless, there is increase in favoring the public availability of cannabis, largely for the management of more than 50 medical conditions.

Steroid Sparing Effects of Methotrexate and Mycophenolate in Uveitis

Patients with noninfectious uveitis (intermediate, posterior uveitis, or panuveitis) often require high dose corticosteroids and therefore may need steroid-sparing DMARD therapy. The FAST study investigated the corticosteroid-sparing effect of methotrexate or mycophenolate mofetil in adults with noninfectious uveitis.