Effectiveness of subcutaneous methotrexate in patients with rheumatoid arthritis and its long-term persistence

Methotrexate has been used as the gold-standard therapy in patients with rheumatoid arthritis (RA) for more than 30 years. However, there is limited information on long-term effectiveness. The aim of this study was to describe the effectiveness of subcutaneous methotrexate (MTX SC) and its long-term persistence in real life in patients diagnosed with RA.

We conducted an analytical retrospective cohort study of patients with RA treated at a reference center in Colombia. We included participants older than 18 years-old with a minimum of one year of follow-up using MTX SC. The main endpoint was to evaluate the changes in the level of disease activity through the DAS28 index from 6 to 48 months of follow-up. Survival curves were estimated using the Kaplan-Meier method to compare different therapies with MTX SC. A p-value<0.05 was considered statistically significant.

877 patients with RA were included, with a median age of 65 [RIQ: 57-73] years, 84% of whom were women. Therapeutic success was achieved in 83% of the population considering those who were maintained in low activity or remission during the follow-up period.

This study shows the proportion of those who started with active disease, meanwhile those in remission and low activity increased from 6 months to the end of follow-up when MTX SC is used appropriately. Effectiveness and persistence of MTX SC over time can be extended up to 48 months during follow-up.