Tapering subcutaneous methotrexate causes more disease flares compared with tapering oral administration in established rheumatoid arthritis patients

Lara D. Veeken, vol. 61, pp. e216–e218

Abstract

Dear Editor, Thanks to improved treatment strategies, disease remission in RA patients has become more common. As a result, current guidelines recommend to consider tapering DMARDs in patients who are in sustained remission, which may include MTX [1]. Previous research has shown that s.c. MTX may have a better bioavailability, efficacy and tolerability in active RA compared with oral MTX [2, 3]. However, the higher efficacy might be a disadvantage when tapering s.c. MTX is considered. Therefore the aim of this study is to compare the cumulative flare rates after 1 year between RA patients who taper oral and s.c. MTX. Data from the TApering strategies in rheumatoid arthritis (TARA) trial were used [4]. In this trial, established RA patients with well-controlled disease, defined as DAS ≤2.4 and a 44-joint swollen joint count (SJC44) ≤1, using one or more conventional synthetic DMARD...

Authors 4

1. Agnes E M Looijen corresponding

   Erasmus MC

   Affiliation as printed

   Department of Rheumatology, Erasmus University Medical Centre , Rotterdam

2. Elise van Mulligen Aachen Department of Rheumatology, Leiden University Medical Centre

   Leiden University · Erasmus MC · Leiden University Medical Center

   Affiliation as printed

   Department of Rheumatology, Erasmus University Medical Centre , Rotterdam

   Department of Rheumatology, Leiden University Medical Centre , Leiden, The Netherlands

3. Annette H M van der Helm–van Mil Aachen Department of Rheumatology, Leiden University Medical Centre

   Leiden University · Erasmus MC · Leiden University Medical Center

   Affiliation as printed

   Department of Rheumatology, Erasmus University Medical Centre , Rotterdam

   Department of Rheumatology, Leiden University Medical Centre , Leiden, The Netherlands

4. Pascal H P de Jong

   Erasmus MC

   Affiliation as printed

   Department of Rheumatology, Erasmus University Medical Centre , Rotterdam