Next Article in Journal
Neuroimaging Studies on Disorders of Consciousness: A Meta-Analytic Evaluation
Previous Article in Journal
Rational Use of CT-Scan for the Diagnosis of Pneumonia: Comparative Accuracy of Different Strategies
Previous Article in Special Issue
Golimumab for Rheumatoid Arthritis
Article Menu
Issue 4 (April) cover image

Export Article

Open AccessPerspective
J. Clin. Med. 2019, 8(4), 515; https://doi.org/10.3390/jcm8040515

How to Get the Most from Methotrexate (MTX) Treatment for Your Rheumatoid Arthritis Patient?—MTX in the Treat-to-Target Strategy

1
Botnar Research Centre, NDORMS, University of Oxford, Windmill Road, Oxford OX3 7LD, UK
2
Rheumatology unit, University Hospital La Paz, Institute for Health Research–IdiPAZ, Universidad Autonoma de Madrid, 28046 Madrid, Spain
3
St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
4
Paris Descartes University, Sorbonne Paris Cité, Rheumatology Department, Cochin Hopital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France
5
SAINBIOSE, INSERM U1059, Université de Lyon, Saint-Etienne, France Service de Rhumatologie, CHU Saint-Etienne, 42055 Saint-Etienne, France
6
Division of Rheumatology, Medical University Department, Kantonsspital Aarau, 5001 Aarau, Switzerland
*
Author to whom correspondence should be addressed.
Received: 13 March 2019 / Revised: 10 April 2019 / Accepted: 11 April 2019 / Published: 15 April 2019
  |  
PDF [342 KB, uploaded 15 April 2019]

Abstract

Methotrexate (MTX) is a remarkable drug with a key role in the management of rheumatoid arthritis (RA) at every stage of its evolution. Its attributes include good overall efficacy for signs and symptoms, inhibition of structural damage and preservation of function with acceptable and manageable safety, a large dose-titratable range, options for either an oral or parenteral route of administration, and currently unrivalled cost-effectiveness. It has a place as a monotherapy and also as an anchor drug that can be safely used in combination with other conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or used concomitantly with biological DMARDs or targeted synthetic DMARDs. MTX is not without potential issues regarding toxicity, notably hepatotoxicity and bone marrow toxicity, as well as tolerability problems for some, but not all, patients. But many of these issues can be mitigated or managed. In the face of a welcome expansion in available targeted therapies for the treatment of RA, MTX looks set to remain at the foundation of pharmacotherapy for the majority of people living with RA and other inflammatory rheumatic diseases. In this article, we provide an evidence-based discussion as to how to achieve the best outcomes with this versatile drug in the context of a treat-to-target strategy for the management of RA. View Full-Text
Keywords: methotrexate; rheumatoid arthritis; tolerability; efficacy; posology; titration; oral route; subcutaneous route; bioavailability; effectiveness methotrexate; rheumatoid arthritis; tolerability; efficacy; posology; titration; oral route; subcutaneous route; bioavailability; effectiveness
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Taylor, P.C.; Balsa Criado, A.; Mongey, A.-B.; Avouac, J.; Marotte, H.; Mueller, R.B. How to Get the Most from Methotrexate (MTX) Treatment for Your Rheumatoid Arthritis Patient?—MTX in the Treat-to-Target Strategy. J. Clin. Med. 2019, 8, 515.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top