Methotrexate - Optimal dosage and

route of administration

Taken from NRAS magazine, Winter 2008

Effect sizes (ES) and odds ratios (OR) for clinical, radiological and toxicity outcomes were calculated and compared between study groups using methotrexate in different dosages or via different routes.

Out of 1748 references found, 38 publications were included in the review. The review concluded that the optimal evidence-based dosing and routing recommendation for methotrexate in RA is:

• Starting on methotrexate 15mg/week orally, escalating with 5mg/month to 25-30mg/week, or the highest tolerable dose, with a subsequent switch to subcutaneous in case of insufficient response