Oral to subcutaneous methotrexate dose-conversion strategy in the treatment of rheumatoid arthritis

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Oral to subcutaneous methotrexate dose-conversion strategy in the treatment of rheumatoid arthritis

Methotrexate, formerly called as amethopterin is used to treat severe psoriasis and rheumatoid arthritis (RA). Usually, it is given when other cpnventional medications fail to relieve the symptoms. For the treatment of RA when there is no contraindication, both the American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) guidelines recommend the use of methotrexate (MTX).

As MTX is the bedrock of RA therapy, absorption saturation compromises its oral bioavailability.

The differences in the relative bioavailability of oral versus subcutaneous (SC) MTX reveal the need for guidance on successful dose-conversion techniques. Schiff M H et al compared MTX PK profiles as a result of MTX administration via three different treatment administrations: oral, SC MTX administered via an auto-injector (MTXAI) into the abdomen (MTXAIab) and into the thigh (MTXAIth). A dose-conversion method based on the bioavailability of MTX from oral and SC administration has been established in this study. Results suggested that SC administration imparted the higher exposure of MTX than the same dose given orally. Dose-proportional exposure was seen with SC MTX unlike the exposure limitations of oral MTX.

Source:

Rheumatology International

Link to the source:

http://link.springer.com/article/10.1007/s00296-016-3621-1

Original title of article:

Oral to subcutaneous methotrexate dose-conversion strategy in the treatment of rheumatoid arthritis

Authors:

 Michael H. Schiff et al.

Rheumatology International
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