Optimal administration and dosage of methotrexate

Clinical and Experimental Rheumatology

Volumn 28, Issue 5 SUPPL. 61, 2010, Pages

  Braun, J ^a  

^a Rheumazentrum Ruhrgebiet ^*  (Germany)

Author keywords

Administration; Dosage; Methotrexate

Indexed keywords

CORTICOSTEROID; DISEASE MODIFYING ANTIRHEUMATIC DRUG; FOLIC ACID; FOLINIC ACID; HYDROXYCHLOROQUINE; LEFLUNOMIDE; METHOTREXATE; NONSTEROID ANTIINFLAMMATORY AGENT; PLACEBO; SALAZOSULFAPYRIDINE; TUMOR NECROSIS FACTOR INHIBITOR; COBALAMIN; PREDNISONE; REDUCED FOLATE CARRIER; TETRAHYDROFOLIC ACID;

AREA UNDER THE CURVE; ARTICLE; BONE MARROW TOXICITY; DOSE RESPONSE; DRUG ABSORPTION; DRUG ADMINISTRATION; DRUG BIOAVAILABILITY; DRUG CLEARANCE; DRUG DOSE ESCALATION; DRUG EFFICACY; DRUG HALF LIFE; DRUG TREATMENT FAILURE; DRUG WITHDRAWAL; FOLIC ACID DEFICIENCY; HUMAN; JUVENILE RHEUMATOID ARTHRITIS; MONOTHERAPY; PATIENT MONITORING; PRIORITY JOURNAL; PROGNOSIS; RHEUMATOID ARTHRITIS; TREATMENT OUTCOME; UNSPECIFIED SIDE EFFECT; CLINICAL EFFECTIVENESS; CLINICAL PRACTICE; DAS28; DRUG DOSAGE FORM COMPARISON; DRUG DOSE COMPARISON; DRUG SAFETY; DRUG TOLERABILITY; ENZYME MECHANISM; FOLIC ACID BLOOD LEVEL; MORTALITY RATE; OUTCOME ASSESSMENT; RANDOMIZED CONTROLLED TRIAL (TOPIC); TREATMENT WITHDRAWAL;

ANTIRHEUMATIC AGENTS; ARTHRITIS, RHEUMATOID; BIOLOGICAL AVAILABILITY; DRUG ADMINISTRATION ROUTES; DRUG ADMINISTRATION SCHEDULE; DRUG INTERACTIONS; FOLIC ACID DEFICIENCY; HUMANS; METHOTREXATE; PATIENT SELECTION; TREATMENT OUTCOME;

EID: 78650617515     PISSN: 0392856X     EISSN: 1593098X     Source Type: Journal    
DOI: None     Document Type: Article

References (68)

1. CRONSTEIN B: The mechanism of action of methotrexate. Rheum Dis Clin North Am 1997;23:739-55.
2. BRAUN J, RAU R: An update on methotrexate. Curr Opin Rheumatol 2009;21:216-23.
3. CRONSTEIN B: How does methotrexate suppress inflammation? Clin Exp Rheumatol 2010;28(Suppl. 61): S21-S23.
4. GUBNER R, AUGUST S, GINSBERG V: Therapeutic suppression of tissue reactivity. II. Effect of aminopterin in rheumatoid arthritis and psoriasis. Am J Med Sci 1951;221:176-82.
5. THOMPSON RN, WATTS C, EDELMAN J, ESDAILE J, RUSSELL AS: A controlled two-centre trial of parenteral methotrexate therapy for refractory rheumatoid arthritis. J Rheumatol 1984;11:760-3
6. WEINBLATT ME, COBLYN JS, FOX DA et al.: Efficacy of low-dose methotrexate in rheumatoid arthritis. N Engl J Med 1985;312:818-22.
7. WILLIAMS HJ, WILLKENS RF, SAMUELSON CO Jr et al.: Comparison of low-dose oral pulse methotrexate and placebo in the treatment of rheumatoid arthritis. A controlled Clinical trial. Arthritis Rheum 1985;28:721-30.
8. ANDERSEN PA, WEST SG, O'DELL JR, VIA CS, CLAYPOOL RG, KOTZIN BL: Weekly pulse methotrexate in rheumatoid arthritis. Clinical and immunologic effects in a randomized, double-blind study. Ann Intern Med 1985;103:489-96.
9. TUGWELL P, BENNETT K, GENT M: Methotrexate in rheumatoid arthritis. Ann Intern Med 1987;107:581-3.
10. BATHON JM, MARTINI RW, FLEISCHMANN RM et al.: A comparison of etanercept and methotrexate in patients with earlyrheumatoid arthritis. N Engl J Med 2000;343:1586-93.
11. PINCUS T, YAZICI Y, SOKKA T, ALETAHA D, SMOLEN JS: Methotrexate as the "anchor drug" for the treatment of early rheumatoid arthritis. Clin Exp Rheumatol 2003;21(Suppl. 31): S179-85.
12. FURST DE, KOEHNKE R, BURMEISTER LF, KOHLER J, CARGILL I: Increasing methotrexate effect with increasing dose in the treatment of resistant RA. J Rheumatol 1989;16:313-20.
13. TUGWELL P, BENNETT K, GENT M: Methotrexate in rheumatoid arthritis. Indications, contraindications, efficacy, and safety. Ann Intern Med 1987;107:358-66.
14. WLUKA A, BUCHBINDER R, MYLVAGANAM A et al.: Longterm methotrexate use in rheumatoid arthritis: 12 year followup of 460 patients treated in community practice. J Rheumatol 2000;21:1864-71.
15. SANY J, ANAYA JM, LUSSIEZ V, COURET M, COMBE B, DAURES JP: Treatment of rheumatoid arthritis with methotrexate: a prospective open long term study of 191 cases. J Rheumatol 1991;18:1323-7.
16. BUCHBINDER R, HALL S, SAMBROOK PN et al.: Methotrexate therapy in rheumatoid arthritis: A life table review of 587 patients treated in community practice. J Rheumatol 1993;20:639-44.
17. KRAUSE D, SCHLEUSSER B, HERBORN G, RAU R: Response to methotrexate treatment is associated with reduced mortality in patients with severe rheumatoid arthritis. Arthritis Rheum 2000;43:14-21.
18. CHOI HK, HERNÁN MA, SEEGER JD, ROBINS JM, WOLFE F: Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet 2002;359:1173-7.
19. MORGAN SL, BAGGOTT JE, VAUGHN WH: Supplementation with folic acid during methotrexate therapy for rheumatoid arthritis. Ann Intern Med 1994;121:833-41.
20. MORGAN SL, BAGGOT JE: Folate supplementation during MTX therapy for rheumatoid arthritis Clin Exp Rheumatol 2010;28(Suppl. 61): S102-S109.
21. AMERICAN COLLEGE OF RHEUMATOLOGY SUB-COMMITTEE ON RHEUMATOID ARTHRITIS GUIDE-LINES: Guidelines for the management of rheumatoid arthritis: 2002 Update. Arthritis Rheum 2002;46:328-46.
22. SOKKA T, MÄKINEN H: Drug management of early rheumatoid arthritis - 2008. Best Pract Res Clin Rheumatol 2009;23:93-102.
23. VISSER K, KATCHAMART W, LOZA E et al.: Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: Integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. Ann Rheum Dis 2009;68:1086-93.
24. GAUJOUX-VIALA C, SMOLEN JS, LANDEWÉ R et al.: Current evidence for the management of rheumatoid arthritis with synthetic disease-modifying antirheumatic drugs: a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis 2010;69:1004-9.
25. KATCHAMART W, TRUDEAU J, PHUMETHUM V, BOMBARDIER C: Methotrexate monotherapy versus methotrexate combination therapy with non-biologic disease modifying anti-rheumatic drugs for rheumatoid arthritis. Cochrane Database Syst Rev 2010;4: CD008495.
26. FURST DE, KEYSTONE EC, FLEISCHMANN R et al.: Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2009. Ann Rheum Dis 2010;69(Suppl. 1):12-29.
27. VISSER K, VAN DER HEIJDE D: Optimal dosage and route of administration of methotrexate in rheumatoid arthritis: A systematic review of the literature. Ann Rheum Dis 2009;68:1094-9.
28. ALBRECHT K, MUELLER-LADNER U: Side effects and management of side effects of methotrexate in rheumatoid arthritis. Clin Exp Rheumatol 2010;28(Suppl. 61): S95-S101.
29. HOEKSTRA M, HAAGSMA C, NEEF C, PROOST J, KNUIF A, VAN DE LAAR M: Bioavailability of higher dose methotrexate comparing oral and subcutaneous administration in patients with rheumatoid arthritis. J Rheumatol 2004;31:645-8.
30. JUNDT JW, BROWNE BA, FIOCCO GP, STEELE AD, MOCK D: A comparison of low dose methotrexate bioavailability: Oral solution, oral tablet, subcutaneous and intramuscular dosing. J Rheumatol 1993;20:1845-9.
31. OGUEY D, KÖLLIKER F, GERBER NJ, REICHEN J: Effect of food on the bioavailability of low-dose methotrexate in patients with rheumatoid arthritis. Arthritis Rheum 1992;35:611-4.
32. BANNWARTH B, PEHOURCQ F, SCHAEVERBAEKE T, DEHAIS J: Clinical pharmacokinetics of low-dose pulse methotrexate in rheumatoid arthritis. Clin Pharmacokin 1996;30:194-210.
33. MATHERLY LH, GOLDMAN DI: Membrane transport of folates. Vitam Horm 2003;66:403-56.
34. TUKOVÁ J, CHLÁDEK J, NEMCOVÁ D, CHLÁ DKOVÁ J, DOLEZALOVÁ P: Methotrexate bioavailability after oral and subcutaneous administration in children with juvenile idiopathic arthritis. Clin Exp Rheumatol 2009;27:1047-53.
35. BECKER ML, VAN HAANDEL L, GAEDIGK R et al.: Analysis of intracellular methotrexate polyglutamates in patients with juvenile idiopathic arthritis: effect of route of administration on variability in intracellular methotrexate polyglutamate concentrations. Arthritis Rheum 2010;62:1803-12.
36. DALRYMPLE J, STAMP L, O'DONNELL J et al.: Pharmacokinetics of oral methotrexate in patients with rheumatoid arthritis. Arthritis Rheum 2008;58:3299-308
37. STAMP LK, O'DONNELL JL, CHAPMAN PT et al.: Methotrexate polyglutamate concentrations are not associated with disease control in rheumatoid arthritis patients receiving long-term methotrexate therapy. Arthritis Rheum 2010;62:359-68.
38. ROON EN, VAN LAAR M A F J: Methotrexate bioavailability. Clin Exp Rheumatol 2010;28(Suppl. 61): S27-S32.
39. AHERN M, BOOTH J, LOXTON A, MCCARTHY P, MEFFIN P, KEVAT S: Methotrexate kinetics in rheumatoid arthritis: is there an interaction with nonsteroidal antiinflammatory drugs? J Rheumatol 1988:15: 1356-60.
40. WEINBLATT ME: Drug interactions with non steroidal anti-inflammatory drugs (NSAIDs). Scand J Rheumatol 1989; (Suppl. 83):7-10.
41. STEWART CF, FLEMING RA, ARKIN CR, EVANS WE: Coadministration of naproxen and low-dose methotrexate in patients with rheumatoid arthritis. Clin Pharmacol Ther 1990;47:540-6.
42. STEWART CF, FLEMING RA, GERMAIN BF, SELEZNICK MJ, EVANS WE: Aspirin alters methotrexate disposition in rheumatoid arthritis patients. Arthritis Rheum 1991;34:1514-20.
43. TRACY TS, KROHN K, JONES DR, BRADLEY JD, HALL SD, BRATER DC: The effects of a salicylate, ibuprofen and naproxen on the disposition of methotrexate in patients with rheumatoid arthritis. Eur J Clin Pharmacol 1992;42:121-5.
44. TRACY TS, WORSTER T, BRADLEY JD, GREENE PK, BRATER DC: Methotrexate disposition following concomitant administration of ketoprofen, piroxicam and flurbiprofen in patients with rheumatoid arthritis. Br J Clin Pharmacol 1994;37:453-6.
45. KREMER JM, HAMILTON RA: The effects of nonsteroidal antiinflammatory drugs on methotrexate (MTX) pharmacokinetics: impairment of renal clearance of MTX at weekly maintenance doses but not at 7.5 mg. J Rheumatol 1995;22:2072-7.
46. KREMER JM, PETRILLO GF, HAMILTON RA: Examination of pharmacokinetic variables in a cohort of patients with rheumatoid arthritis beginning therapy with methotrexate compared with a cohort receiving the drug for a mean of 81 months. J Rheumatol 1995;22:41-4.
47. FURST DE: Practical clinical pharmacology and drug interactions of low-dose methotrexate therapy in rheumatoid arthritis. Br J Rheumatol 1995;34(Suppl. 2):20-5.
48. ODELL JR, HAIRE CE, ERIKSON N et al.: Treatment of rheumatoid arthritis with methotrexate alone, sulfasalazine and hydroxychloroquine, or a combination of all three medications. N Engl J Med 1996;334:1287-91.
49. O'DELL JR, LEFF R, PAULSEN G et al.: Treatment of rheumatoid arthritis with methotrexate and hydroxychloroquine, methotrexate and sulfasalazine, or a combination of the three medications. Results of a two-year, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2002;46:1164-70.
50. MAINI RN, BREEDVELD FC, KALDEN JR et al.: Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor alpha monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritis. Arthritis Rheum 1998;41:1552-63.
51. LIPSKY PE, VAN DER HEIJDE DM, ST CLAIR EW et al.: Infliximab and methotrexate in the treatment of rheumatoid arthritis. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med 2000;343:1594-602.
52. HOCHBERG MC, TRACY JK, HAWKINS-HOLT M, FLORES RH: Comparison of the efficacy of the tumour necrosis factor alpha blocking agents adalimumab, etanercept and infliximab when added to methotrexate in patients with active rheumatoid arthritis. Ann Rheum Dis 2003;62(Suppl. 2): ii13-ii16.
53. ST. CLAIR EW, VAN DER HEIJDE DM, SMOLEN JS et al.: Combination of infliximab and methotrexate therapy for early rheumatoid arthritis: a randomized, controlled trial. Arthritis Rheum 2004;50:3432-43.
54. CARMICHAEL SJ, BEAL J, DAY RO, TETT SE: Combination therapy with methotrexate and hydroxychloroquine for rheumatoid arthritis increases exposure to methotrexate. J Rheumatol 2002;29:2077-83.
55. MROCZKOWSKI PJ, WEINBLATT ME, KREMER JM: Methotrexate and leflunomide combination therapy for patients with active rheumatoid arthritis. Clin Exp Rheumatol 1999;17(Suppl. 18): S66-8.
56. WEINBLATT ME, KREMER JM, COBLYN JS et al.: Pharmacokinetics, safety and efficacy of combination treatment with methotrexate and leflunomide in patients with active rheumatoid arthritis. Arthritis Rheum 1999;42:1322-8.
57. WEINBLATT ME, DIXON JA, FALCHUK KR: Serious liver disease in a patient receiving methotrexate and leflunomide. Arthritis Rheum 2000;43:2609-11.
58. KREMER JM, GENOVESE MC, CANNON GW et al.: Concomitant leflunomide therapy in patients with active rheumatoid arthritis despite stable doses of methotrexate. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 2002;137:726-33.
59. KREMER J, GENOVESE M, CANNON GW et al.: Combination leflunomide and methotrexate (MTX) therapy for patients with active rheumatoid arthritis failing MTX monotherapy: open-label extension of a randomized, double-blind, placebo controlled trial. J Rheumatol 2004;31:1521-31.
60. HILLR L. TOPLISS DJ. PURCELL PM: Pancytopenia associated with leflunomide and methotrexate. Ann Pharmacother 2003;37:149
61. VARELA-MOREIRA SG, MURPHY MM, SCOTT JM: Cobalamin, folic acid, and homocysteine. Nutr Rev 2009;67(Suppl. 1): S69-72.
62. PFEIFFER CM, CAUDILL SP, GUNTER EW, OSTERLOH J, SAMPSON EJ: Biochemical indicators of B vitamin status in the US population after folic acid fortification: results from the National Health and Nutrition Examination Survey 1999-2000. Am J Clin Nutr 2005;82:442-50.
63. GENEST JJ JR, MCNAMARA JR, SALEM DN et al.: Plasma homocyst (e) ine levels in men with premature coronary artery disease. J Am Coll Cardiol 1990;16:1114-9
64. ROBBINS L et al.: Methotrexate use in rheumatic diseases: comparison of efficacy and tolerance of oral, intramuscular and subcutaneous methods of administration. Arthritis Rheum 1997;40:230.
65. ROZIN A, SCHAPIRA D, BALBIR-GURMAN A et al.: Relapse of rheumatoid arthritis after substitution of oral for parenteral administration of methotrexate. Ann Rheum Dis 2002;61:756-7.
66. HOEKSTRA M, HAAGSMA C, NEEFC, PROOST J, KNUIF A, VAN DE LAAR M: Splitting highdose oral methotrexate improves bioavailability: a pharmacokinetic study in patients with rheumatoid arthritis. J Rheumatol 2006;33:481-5.
67. BRAUN J, KÄSTNER P, FLAXENBERG P et al.; MC-MTX.6/RH STUDY GROUP: Comparison of the clinical efficacy and safety of subcutaneous versus oral administration of methotrexate in patients with active rheumatoid arthritis: Results of a six-month, multicenter, randomized, double-blind, controlled, phase IV trial. Arthritis Rheum 2008;58:73-81.
68. VERSTAPPEN SM, JACOBS JW, VAN DER VEEN MJ et al.; UTRECHT RHEUMATOID ARTHRITIS COHORT STUDY GROUP: Intensive treatment with methotrexate in early rheumatoid arthritis: aiming for remission. Computer Assisted Management in Early Rheumatoid Arthritis (CAMERA, an open-label strategy trial). Ann Rheum Dis 2007;66:1443-9.