Subcutaneous Methotrexate to Cut Costs?: Table 1.

Abstract

To the Editor: Methotrexate (MTX) is widely used as the drug of choice in the treatment of rheumatoid arthritis (RA) and it is advocated as such by the British Society for Rheumatology guidelines1. To date, oral MTX has been used because of patient preference for its once-weekly dosing regime and low costs. Tumor necrosis factor-α inhibitors (anti-TNF-α) have become increasingly popular in treating RA2. However, anti-TNF-α drugs are expensive and have been shown to increase the risk of skin and soft tissue infections and reactivation of tuberculosis and possibly malignancy3. MTX is currently available for oral or parenteral administration. Although current guidelines encourage use of MTX as first-line therapy, they do not specify the route of administration1,4. Several studies describe the increased efficacy5 … Address correspondence to Dr. Bawa; E-mail: sandeep.bawa{at}ggc.scot.nhs.uk