Methotrexate: injection may be better than oral treatment for early rheumatoid arthritis, research group claims

People who take methotrexate by mouth for rheumatoid arthritis could see better results using a subcutaneous version of the drug, according to research in the Annals of the Rheumatic Diseases.
A total of 666 people from Canada and the US were enrolled in the study which aimed to assess the difference in outcome of oral versus subcutaneous methotrexate as an initial therapy for people with early rheumatoid arthritis.
Of the group, 417 received the oral therapy and 249 were given the drug subcutaneously. Those prescribed subcutaneous methotrexate were given a generally higher dose.
At one year, 49% of people initially treated with subcutaneous methotrexate had changed treatment compared with 77% of those treated orally.
Subcutaneous methotrexate was associated with a reduced average score in terms of disease activity and a lower rate of treatment failure.
“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,” the research team concludes.
A spokesman from Arthritis Research UK comments:
“We really welcome this new study, which provides some promising results for people with inflammatory arthritis that are being treated with the drug methotrexate. As with many other drugs used to treat arthritis, methotrexate can have significant side-effects and doesn’t work for everyone.
“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.”

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