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Weekly Methotrexate As Effective as Twice-Weekly For Rheumatoid Arthritis

Twice-weekly methotrexate for patients with rheumatoid arthritis is no more efficient than is the currently used once-weekly regimen, suggests a study from India.

Researchers from Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, undertook this 16-week double blind, controlled trial of twice-weekly versus weekly regimens of methotrexate (MTX).

Eighty people fulfilling the American College of Rheumatology (ACR) criteria for rheumatoid arthritis (RA) participated in this study. The researchers determined patients achieving ACR scores of 20 and 50 at both eight and 16 weeks and also examined the incidence of hepatotoxicity.

Of the 80 patients, 66 completed eight weeks of study and 53 completed 16 weeks. Most of those who withdrew from the study did so because of inefficacy.

At eight weeks, the ACR 20 response (24/34 in once weekly and 22/32 in twice weekly) and ACR 50 response (16/34 in once weekly and 16/32 in twice weekly) in both groups were similar.

Even at 16 weeks, there was no significant difference in ACR 20 and ACR 50 responses. There were similar results in an intent-to-treat analysis.

Five patients in each group had a mild reversible rise in transaminases.
Rheumatol Int (2002) 22: 1-4. "Methotrexate twice weekly vs once weekly in rheumatoid arthritis: a pilot double-blind, controlled study"

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