Oral, Injected Methotrexate Have Similar Efficacy in JIA

Injected methotrexate could be discontinued in favor of oral administration in juvenile idiopathic arthritis

WEDNESDAY, May 30 (HealthDay News) -- Oral and injected methotrexate are equally effective for treating children with juvenile idiopathic arthritis, according to a study published online May 30 in Arthritis Care & Research.

Ariane Klein, M.D., from Asklepios Klinik Sankt Augustin in Germany, and colleagues retrospectively analyzed data from 411 patients with juvenile idiopathic arthritis, where 63 percent received oral methotrexate and 37 percent received subcutaneous methotrexate for at least six months. The weekly dosage was similar in both groups, and similar numbers also received steroids. The efficacy of therapy was assessed using the Pediatric American College of Rheumatology (PedACR) criteria.

The researchers found that a similar percentage of patients achieved PedACR scores for 30 percent improvement after six months of treatment in both groups (73 and 72 percent for oral and injected, respectively). There was at least one documented adverse event for 22 percent of patients treated with oral methotrexate and 27 percent treated with injected methotrexate. While similar proportions of each group discontinued treatment, significantly more patients in the subcutaneous group discontinued methotrexate due to adverse events.

"In this retrospective analysis, parenteral methotrexate was not superior to oral administration regarding efficacy and tolerability," Klein and colleagues conclude. "The often unpopular and more expensive parenteral application could probably be spared without consequences."

The German Methotrexate Registry is sponsored by Wyeth Biopharma, acquired by Pfizer; several authors disclosed financial ties to Wyeth Biopharma as well as other pharmaceutical companies.

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