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Key findings from studies of methotrexate tapering and withdrawal in rheumatoid arthritis

Sujith Subesinghe1, Ian C Scott2,3

  • 1a 1 Department of Rheumatology , 4th Floor Tower Wing, Guy's Hospital, London, SE1 9RT, UK.

Expert Review of Clinical Pharmacology
|August 21, 2015
PubMed

Insights

Reducing methotrexate dosage can help manage rheumatoid arthritis (RA) side effects. This review explores the risks and benefits of tapering or stopping methotrexate, alone or with other RA drugs.

Area of Science:

  • Rheumatology
  • Pharmacology

Background:

  • Methotrexate is a primary treatment for rheumatoid arthritis (RA).
  • Adverse effects necessitate dose reduction or withdrawal.
  • Minimizing methotrexate to maintain remission is a clinical objective.

Purpose of the Study:

  • To review studies on methotrexate tapering and withdrawal in RA.
  • To assess risks associated with methotrexate cessation.
  • To evaluate the impact of gradual dose reduction on RA outcomes.

Main Methods:

  • Systematic review of existing literature.
  • Analysis of studies involving methotrexate monotherapy.
  • Examination of methotrexate withdrawal in combination therapy and with biologics.

Main Results:

  • Data on methotrexate withdrawal risks in RA is limited.
  • Gradual dose reduction (tapering) may mitigate flare risk.
  • Outcomes vary based on whether methotrexate is used alone or in combination therapy.

Conclusions:

  • Further research is needed to fully understand methotrexate withdrawal risks in RA.
  • Tapering strategies may be crucial for minimizing RA flares upon methotrexate cessation.
  • Clinical practice should consider individualized approaches to methotrexate dose reduction.
Keywords:
biologicsdisease-modifying anti-rheumatic drugsmethotrexateoutcomesrheumatoid arthritistaperingwithdrawal

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