ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 517

Evaluation of the Effectiveness of Injectable Methotrexate for the Treatment of Rheumatoid Arthritis

Jenny Wan1, Michele Spence2, Fang Niu2, Rita Hui3, Stephen Cheng1, Logan Saito4 and Antony Lin5, 1Kaiser Permanente Drug Information Services - California Regions, Downey, CA, 2Kaiser Permanente Pharmacy Outcomes Research Group, Downey, CA, 3Kaiser Permanente Pharmacy Outcomes Research Group, Oakland, CA, 4Kaiser Permanente Southern California Clinical Pharmacy Services, Downey, CA, 5Rheumatology, Kaiser Permanente Fontana Medical Center, Fontana, CA

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: methotrexate (MTX) and rheumatoid arthritis (RA)

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, November 5, 2017

Title: Rheumatoid Arthritis – Small Molecules, Biologics and Gene Therapy Poster I: Comorbidities and Adverse Events; Efficacy and Safety of Small Molecules

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Systemic methotrexate (MTX) is the first-line disease-modifying antirheumatic drug (DMARD) for treating early and established rheumatoid arthritis (RA). When compared to oral MTX, subcutaneous MTX enhances tolerability with a significant reduction in gastrointestinal side effects. Subcutaneous MTX has further demonstrated better clinical efficacy than oral MTX in patients who were both oral MTX-experienced and MTX-naïve. This study aimed to better quantify the role of subcutaneous MTX in delaying initiation of biologic DMARD (bioDMARD).

 

Methods:

In this retrospective cohort analysis, new users of oral MTX were identified between January 1, 2008 and December 31, 2014 (N=42,413). Patients aged 18 years or older with continuous health plan membership, drug benefit, and RA diagnosis (n=7,968) were included in this analysis. Patients who had at least one ≥2.5 mg increase in the weekly oral MTX dose (n=3,970) were compared to those who switched from oral MTX to subcutaneous MTX (n=421). The primary outcome was the likelihood of initiating a bioDMARD, which was analyzed using Cox proportional hazard model. Other outcomes measured were the timing of changes in treatment, and doses of oral or subcutaneous MTX at the time of switches or at the end of follow-up.

 

Results:

Comparing the two treatment strategies, the unadjusted and adjusted Cox regression analyses showed no significant difference in the likelihood of initiating bioDMARD. Factors associated with a reduced likelihood of initiation of bioDMARD included older age, African American, and the initiation of azathioprine. In contrast, the use of systemic prednisone at baseline and higher erythrocyte sedimentation rate (ESR) during follow-up were associated with an increased likelihood of initiation of bioDMARD. Among the patients who started bioDMARD, more than two-third of the patients never received MTX at doses >20 mg/week prior to initiating bioDMARD. Compared to patients who had a dose increase in oral MTX, patients who switched to subcutaneous MTX significantly delayed the use of bioDMARDs by 9 months (p<0.001).

 

Conclusion:

There is no significant difference in the likelihood of initiating bioDMARD between the two treatment strategies. Compared to oral MTX group, switching to subcutaneous MTX delayed the use of bioDMARD by 9 months. Given that bioDMARDs are costly and require injections, switching from oral MTX to subcutaneous MTX before using bioDMARD may be a reasonable alternative for patients who fail oral MTX.

 

 

 

 

 


Disclosure: J. Wan, None; M. Spence, None; F. Niu, None; R. Hui, None; S. Cheng, None; L. Saito, None; A. Lin, None.

To cite this abstract in AMA style:

Wan J, Spence M, Niu F, Hui R, Cheng S, Saito L, Lin A. Evaluation of the Effectiveness of Injectable Methotrexate for the Treatment of Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/evaluation-of-the-effectiveness-of-injectable-methotrexate-for-the-treatment-of-rheumatoid-arthritis/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluation-of-the-effectiveness-of-injectable-methotrexate-for-the-treatment-of-rheumatoid-arthritis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology