Retrospective evaluation of continuation rates following a switch to subcutaneous methotrexate in rheumatoid arthritis patients failing to respond to or tolerate oral methotrexate: the MENTOR study

Scott, David G. I.; Claydon, P.; Ellis, C.J.

doi:10.3109/03009742.2014.910312

Cited by 22 publications

(21 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It acts at multiple points in the inflammatory pathway to improve clinical symptoms and disease control, and treatment adherence is essential for the maintenance of this control (Bello, Perkins, Jay, & Efthimiou, 2017). Subcutaneous (SC) administration has contributed substantially to improving adherence to MTX (Scott, Claydon, & Ellis, 2014). When compared with oral dosing, it offers greater clinical efficacy in both early and long-term disease, and a delay in progression to biological therapy (Bello et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Using video‐based training for button‐free auto‐injection of subcutaneous methotrexate: A pilot study

Homer¹

2019

Musculoskeletal Care

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Using video‐based training for button‐free auto‐injection of subcutaneous methotrexate: A pilot study

Homer¹

2019

Musculoskeletal Care

View full text Add to dashboard Cite

“…Observational studies of patients who switched from parenteral to oral MTX demonstrated high rates of flares in disease activity, with increased gastrointestinal side effects 12 13. A recent cohort study of patients taking subcutaneous MTX after oral MTX found high rates of treatment continuation, with 75% of patients still on treatment at 2 years 14. These observational studies, however, were limited by the lack of a comparator group.…”

Section: Introductionmentioning

confidence: 99%

The comparative effectiveness of oral versus subcutaneous methotrexate for the treatment of early rheumatoid arthritis

et al. 2015

View full text Add to dashboard Cite

ObjectiveTo determine the comparative effectiveness of oral versus subcutaneous methotrexate (MTX) as initial therapy for patients with early rheumatoid arthritis (ERA).MethodsPatients with ERA (symptoms ≤1 year) initiating MTX therapy were included from a multicentre, prospective cohort study. We compared the effectiveness between starting with oral versus subcutaneous MTX over the first year. Longitudinal multivariable models, adjusted for potential baseline and time-varying confounders, were used to compare treatment changes due to inefficacy or toxicity and treatment efficacy (Disease Activity Score-28 (DAS-28), DAS-28 remission and Health Assessment Questionnaire-Disability Index (HAQ-DI)).Results666 patients were included (417 oral MTX, 249 subcutaneous MTX). Patients prescribed subcutaneous MTX were prescribed a higher dose of MTX (mean dose over first three months 22.3 mg vs 17.2 mg/week). At 1 year, 49% of patients initially treated with subcutaneous MTX had changed treatment compared with 77% treated with oral MTX. After adjusting for potential confounders, subcutaneous MTX was associated with a lower rate of treatment failure ((HR (95% CI) 0.55 (0.39 to 0.79)). Most treatment failures were due to inefficacy with no difference in failure due to toxicity. In multivariable models, subcutaneous MTX was also associated with lower average DAS-28 scores (mean difference (−0.38 (95% CI −0.64 to −0.10)) and a small difference in DAS-28 remission (OR 1.2 (95% CI 1.1 to 1.3)). There was no significant difference in sustained remission or HAQ-DI (p values 0.43 and 0.75).ConclusionsInitial treatment with subcutaneous MTX was associated with lower rates of treatment changes, no difference in toxicity and some improvements in disease control versus oral MTX over the first year in patients with ERA.

show abstract

“…Similar data comes from 2 retrospectives studies, where a higher rate of therapy persistence in patients on sMTX than those receiving the drug orally has been observed. 15,17 There are several factors that may explain such good results. Firstly, sMTX is characterized by better tolerance and fewer ADRs.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of subcutaneously administered methotrexate in patients with rheumatoid arthritis

Kotyla¹,

Batko²,

Żuber³

et al. 2019

Adv Clin Exp Med

View full text Add to dashboard Cite

Background. Subcutaneous methotrexate (sMTX) administration is considered more effective than the oral route due to better bioavailability and a lower rate of adverse drug reactions (ADRs); however, clinical data supporting this hypothesis is scarce.Objectives. The aim of the study was to evaluate the efficacy and tolerability of sMTX in patients with active rheumatoid arthritis (RA), including a subset classified as an early stage of RA. Material and methods.A post-marketing, multicenter, open-label, non-randomized, non-interventional study enrolled 771 adult patients with active RA treated with sMTX (Metex ® ) for 2-6 weeks. The evaluation of therapy effectiveness (DAS28-ESR or DAS28-CRP) and monitoring of ADRs was an element of routine patient management. Therapy effectiveness was scored as the achievement of remission or response ( according to European League Against Rheumatism (EULAR)).Results. Among 761 (98.7%) patients that continued sMTX (after 25-31 weeks), clinical response was achieved by 69.5%, remission by 19.2% and low disease activity by 34.2%. Patients aged >60 years were less likely to achieve both remission (odds ratio (OR) = 0.61 (95% confidence interval (95% CI) = 0.39-0.93)) and clinical response (OR = 0.82 (95% CI = 0.71-0.95)), while overweight/obese patients (OR = 1.11 (95% CI = 1.00-1.24)) and those with early RA had greater chance to reach a clinical response (OR = 1. 18 (95% CI = 1.03-1.34)). There were 16 ADRs (no serious or severe). In addition, at least 2-fold increase in alanine transaminase (ALT) activity was noted in 10 patients (1.3%). Conclusions.After 6-month therapy with sMTX, about 70% of patients with RA achieve a clinical response, and remission was observed in 20%. Younger age, overweight/obesity and an early stage of the disease are factors increasing therapy effectiveness; sMTX is well tolerated. EJ. Effectiveness of subcutaneously administered methotrexate in patients with rheumatoid arthritis.

show abstract

Retrospective evaluation of continuation rates following a switch to subcutaneous methotrexate in rheumatoid arthritis patients failing to respond to or tolerate oral methotrexate: the MENTOR study

Cited by 22 publications

References 19 publications

Using video‐based training for button‐free auto‐injection of subcutaneous methotrexate: A pilot study

Using video‐based training for button‐free auto‐injection of subcutaneous methotrexate: A pilot study

The comparative effectiveness of oral versus subcutaneous methotrexate for the treatment of early rheumatoid arthritis

Effectiveness of subcutaneously administered methotrexate in patients with rheumatoid arthritis

Contact Info

Product

Resources

About