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Methotrexate oral vs subcutaneous

Richard B Warren, Ulrich Mrowietz, Ralph von Kiedrowski, Johannes Niesmann, Dagmar Wilsmann-Theis, Kamran Ghoreschi, Ina Zschocke, Thomas M Falk, Norbert Blödorn-Schlicht, Kristian Reich
BACKGROUND: Methotrexate is one of the most commonly used systemic drugs for the treatment of moderate to severe psoriasis; however, high-quality evidence for its use is sparse and limited to use of oral dosing. We aimed to assess the effect of an intensified dosing schedule of subcutaneous methotrexate in patients with moderate to severe plaque-type psoriasis. METHODS: We did this prospective, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial (METOP) at 16 sites in Germany, France, the Netherlands, and the UK...
February 4, 2017: Lancet
S R Quist, J Quist, J Birkenmaier, T Stauch, H P Gollnick
AIMS: The aim of this pilot study was to use microdialysis to evaluate levels of Methotrexate (MTX) directly in psoriatic skin following oral or subcutaneous administration of MTX to elaborate a complete pharmacokinetic profile within the dermal skin. METHODS: Six patients with chronic plaque psoriasis on the arm undergoing treatment with MTX were included in a mono-centre clinical trial. Patients were under treatment with p.o. or s.c. MTX (7.5 and 15 mg) for at least 3 months...
September 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Lauren A Henderson, David Zurakowski, Sheila T Angeles-Han, Andrew Lasky, C Egla Rabinovich, Mindy S Lo
BACKGROUND: There is not yet a commonly accepted, standardized approach in the treatment of juvenile idiopathic uveitis when initial steroid therapy is insufficient. We sought to assess current practice patterns within a large cohort of children with juvenile uveitis. METHODS: This is a cross-sectional cohort study of patients with uveitis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRAnet) registry. Clinical information including, demographic information, presenting features, disease complications, and medications were collected...
February 16, 2016: Pediatric Rheumatology Online Journal
E H Pieter van Dijkhuizen, Juliëtte N Pouw, Andrea Scheuern, Boris Hügle, Sven Hardt, Gerd Ganser, Jasmin Beate Kümmerle-Deschner, Gerd Horneff, Dirk Holzinger, Maja Bulatović Ćalasan, Nico M Wulffraat
OBJECTIVES: Methotrexate (MTX) is the cornerstone disease-modifying anti-rheumatic drug (DMARD) in juvenile idiopathic arthritis (JIA). In Dutch patients, MTX intolerance occurred frequently and was associated with subcutaneous (SC) administration. The aim of this study was to assess the prevalence of MTX intolerance and its association with the route of administration in a German cohort of JIA patients. METHODS: A cross-sectional study of JIA patients on MTX was performed...
January 2016: Clinical and Experimental Rheumatology
Glen S Hazlewood, J Carter Thorne, Janet E Pope, Daming Lin, Diane Tin, Gilles Boire, Boulos Haraoui, Carol A Hitchon, Edward C Keystone, Shahin Jamal, Vivian P Bykerk
OBJECTIVE: To determine the comparative effectiveness of oral versus subcutaneous methotrexate (MTX) as initial therapy for patients with early rheumatoid arthritis (ERA). METHODS: Patients 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))...
June 2016: Annals of the Rheumatic Diseases
Ari M Goldminz, Mayte Suárez-Fariñas, Andrew C Wang, Nicole Dumont, James G Krueger, Alice B Gottlieb
IMPORTANCE: Methotrexate is a first-line systemic agent for treating of psoriasis, although its onset of effects is slower and overall it is less effective than tumor necrosis factor blockers. OBJECTIVE: To differentiate the response of psoriatic disease to adalimumab and methotrexate sodium. DESIGN, SETTING, AND PARTICIPANTS: Single-center, randomized, assessor-blind, 2-arm clinical trial of 30 patients from the outpatient dermatology center of Tufts Medical Center, enrolled from August 18, 2009, to October 11, 2011...
August 2015: JAMA Dermatology
M S Islam, S A Haq, M N Islam, A K Azad, M A Islam, R Barua, M M Hasan, M Mahmood, M Safiuddin, M M Rahman, M F Osmany, N Bari, R S Rumki, F B Rashid
This prospective study was conducted in rheumatology clinic under the department of medicine of Bangabandhu Sheikh Mujib Medical University from December 2004 to December 2005 to asses the efficacy, safety and compliance of subcutaneous methotrexate (MTX) in active rheumatoid arthritis (RA) patients. A total of 92 active rheumatoid arthritis patients according to American College of Rheumatology (ACR) criteria were recruited for the trial for six months. Among them 46 cases belonged to injectable MTX group and 46 cases belonged to oral MTX group...
July 2013: Mymensingh Medical Journal: MMJ
Paweł Kawalec, Alicja Mikrut, Natalia Wiśniewska, Andrzej Pilc
The aim of the present study was to conduct a meta-analysis of the effectiveness of tofacitinib, a novel oral Janus kinase inhibitor, recently approved for the treatment of active rheumatoid arthritis in patients who have failed previous treatment with methotrexate (MTX) or other disease-modifying antirheumatic drugs (DMARDs). A systematic literature search was conducted in PubMed, EMBASE, Cochrane Library, and other databases till 3 May 2013. All included studies were analyzed with the use of the Review Manager 5...
October 2013: Clinical Rheumatology
Sarah Ringold, Shannon Grant, Charmaine Girdish, Carol A Wallace, Sean D Sullivan
OBJECTIVE: To measure adherence and persistence with methotrexate (MTX) and injectable tumor necrosis factor-α (iTNF-α) inhibitors (etanercept, adalimumab) among children prescribed these medications by a rheumatologist. METHODS: Data were obtained from a US pharmacy benefits management firm. Children were included if they were < 18 years of age, had ≥ 1 prescription claim between January 2009 and December 2010 for MTX or an iTNF-α inhibitor that was prescribed by an adult or pediatric rheumatologist...
January 2013: Journal of Rheumatology
H Montaudié, E Sbidian, C Paul, A Maza, A Gallini, S Aractingi, F Aubin, H Bachelez, B Cribier, P Joly, D Jullien, M Le Maître, L Misery, M-A Richard, J-P Ortonne
BACKGROUND/AIM: To define practical use and to specify the ideal method for monitoring the liver toxicity of MTX in the management of psoriasis. OBJECTIVE: To systematically review the literature regarding treatment modalities with methotrexate (MTX) in psoriasis, risk of MTX-mediated liver fibrosis and monitoring of hepatic toxicity. METHODS: A systematic literature search was carried out in Medline, Embase and Cochrane Library databases from 1980 to 2010 searching for randomized controlled trials and observational studies on methods of administering MTX in psoriasis and risk factors and assessment of liver toxicity...
May 2011: Journal of the European Academy of Dermatology and Venereology: JEADV
J Tuková, J Chládek, D Nemcová, J Chládková, P Dolezalová
OBJECTIVE: To compare the bioavailability of oral and subcutaneous methotrexate (MTX) in children with juvenile idiopathic arthritis (JIA). METHODS: Seventeen JIA patients were administered oral (6.1-22.5 mg/m(2)) or subcutaneous (8.8-28.6 mg/m(2)) MTX. Blood samples were drawn pre-dose, and at 1, 2, and 4 hours after administration. Plasma MTX was determined by high-performance liquid chromatography. Non-compartmental pharmacokinetic analysis included the maximum concentration of plasma MTX (C(max)) and the area under the plasma concentration-time curve in the interval of 0-4h (AUC(0-4h))...
November 2009: Clinical and Experimental Rheumatology
J-H Saurat, G Stingl, L Dubertret, K Papp, R G Langley, J-P Ortonne, K Unnebrink, M Kaul, A Camez
BACKGROUND: Biologic therapies such as adalimumab, a tumour necrosis factor antagonist, are safe and effective in the treatment of moderate to severe chronic plaque psoriasis. OBJECTIVES: To compare a biologic agent with methotrexate, a traditional systemic agent, to define clearly the role of biologics in psoriasis. METHODS: Patients with moderate to severe plaque psoriasis were randomized to adalimumab (80 mg subcutaneously at week 0, then 40 mg every other week, n=108), methotrexate (7...
March 2008: British Journal of Dermatology
Lars Klareskog, Désirée van der Heijde, Julien P de Jager, Andrew Gough, Joachim Kalden, Michel Malaise, Emilio Martín Mola, Karel Pavelka, Jacques Sany, Lucas Settas, Joseph Wajdula, Ronald Pedersen, Saeed Fatenejad, Marie Sanda
BACKGROUND: Etanercept and methotrexate are effective in the treatment of rheumatoid arthritis but no data exist on concurrent initiation or use of the combination compared with either drug alone. We aimed to assess combination treatment with etanercept and methotrexate versus the monotherapies in patients with rheumatoid arthritis. METHODS: In a double-blind, randomised, clinical efficacy, safety, and radiographic study, 686 patients with active rheumatoid arthritis were randomly allocated to treatment with etanercept 25 mg (subcutaneously twice a week), oral methotrexate (up to 20 mg every week), or the combination...
February 28, 2004: Lancet
D Kurnik, R Loebstein, E Fishbein, S Almog, H Halkin, S Bar-Meir, Y Chowers
BACKGROUND: Oral methotrexate and folic acid are partly absorbed by a common intestinal transporter. AIM: : To determine the relative bioavailability of oral low-dose methotrexate administered with and without concomitant folic acid vs. subcutaneous administration in patients with stable Crohn's disease. METHODS: Ten patients were randomized to receive their regular maintenance dose of methotrexate (15-25 mg) for three consecutive weeks: orally, orally with 5 mg folic acid or subcutaneously...
July 1, 2003: Alimentary Pharmacology & Therapeutics
A Okano, C Shimazaki, N Ochiai, M Hatsuse, R Takahashi, E Ashihara, T Inaba, N Fujita, Y Noda, M Nakagawa
Reports of cases of mycobacterial infections after SCT are rare. We report a 30-year-old female with a cutaneous infection of Mycobacterium fortuitum 30 months after allogeneic bone marrow transplantation for acute lymphoblastic leukemia. The patient was successfully treated with surgical debridement followed by oral minocycline and clarithromycin. Mycobacterial infections should be considered in SCT patients with undiagnosed refractory chronic cutaneous infection, and surgical debridement is useful for the diagnosis and treatment of such infections...
October 2001: Bone Marrow Transplantation
J W Jundt, B A Browne, G P Fiocco, A D Steele, D Mock
OBJECTIVE: To compare the relative bioavailability of low dose methotrexate (MTX) administered as tablet, oral solution, and subcutaneous (sc) injection to that of intramuscular (im) injection in patients with rheumatoid arthritis (RA). METHODS: Twelve patients meeting the American College of Rheumatology criteria for RA had serial blood MTX concentration samples drawn over a 24-h period after receiving their normal weekly MTX dose. Relative bioavailability (F) of the tablet and oral solution formulations was determined by comparison of the area under the time-versus-serum-concentration curves (AUC) for the 2 different oral formulations as a percentage of the AUC for im injection...
November 1993: Journal of Rheumatology
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