- Odds of achieving a 20% improvement in disease activity per American College of Rheumatology criteria (ACR20) are 3-fold higher with parenteral vs oral methotrexate (MTX) in rheumatoid arthritis.
Why this matters
- Parenteral MTX has greater bioavailability than oral MTX.
- Widespread adoption of parenteral MTX may yield better disease control and a consequent decrease in demand for biological agents.
- Meta-analysis of 4 randomized controlled trials (N=703 patients) identified from a search of PubMed, Web of Science, and EMBASE.
- MTX dose started at 15 mg/week and increased no higher than 25 mg/week.
- Primary outcome: ACR20 at 6 months.
- Funding: None.
- Parental MTX was associated with 3-fold odds of achieving ACR20 at 6 months (OR, 3.02; 95% CI, 1.41-6.46).
- Parental MTX did not carry greater risk for adverse events (P=.82) or adverse events leading to discontinuation (P=.1).
- High heterogeneity across studies (I2=70.07%).