The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Auto-Injectable Methotrexate: New Treatment Option for RA

Auto-Injectable Methotrexate: New Treatment Option for RA

October 14, 2015 • By Susan Bernstein

  • Tweet
  • Email
Print-Friendly Version / Save PDF
Image Credit: Bottom: antares pharma inc./ Top: medac pharma Inc.

Image Credit: Bottom: antares pharma inc./ Top: medac pharma Inc.

Methotrexate has long been a cornerstone of therapy in rheumatoid arthritis. Two new, injectable methotrexate products may help some RA patients for whom oral methotrexate is not as effective or causes adverse effects.

You Might Also Like
  • Effectiveness of Tofacitinib with Methotrexate, Adalimumab Therapy Evaluated in Patients with RA
  • Researchers Find Rheumatologists Are Prescribing Methotrexate Less Often to Treat RA
  • Decernotinib, Subcutaneous Methotrexate Drug Updates, Trials, Approvals
Explore This Issue
October 2015
Also By This Author
  • The ACR’s 2015 Workforce Study Reveals Gap Between Rheumatologist Supply, Patient Demand

Rasuvo and Otrexup are prefilled, auto-injection devices that allow patients to give themselves subcutaneous injections of methotrexate without having to use a separate syringe and vial. Benefits of these new products include convenience and ease, but the drawback is a much higher cost.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Rasuvo is a single-dose auto-injection device that comes in 10 different doses of methotrexate: 7.5, 10, 12.5, 15, 17.5, 20, 22.5, 27.5, and 30 mg. Otrexup is available in doses of 10, 15, 20 or 25 mg per 4 mL.

Oral’s Drawbacks

Typically, RA patients take 15 mg of oral methotrexate each week, although some need a lower or higher dose, says Bella Fradlis, MD, attending physician, Division of Rheumatology, at Montefiore Health System and Assistant Professor at Albert Einstein College of Medicine in New York.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

“The oral preparation of methotrexate seems to be the ‘go-to’ given cost-effectiveness and convenient dosing,” she says. “However, not all patients are able to tolerate oral methotrexate equally well. Some patients experience gastrointestinal side effects, such as nausea or vomiting.”

Bioavailability of oral methotrexate may be only two-thirds of what is absorbed when the drug is injected subcutaneously.

Stomach problems are not the only possible drawback of oral methotrexate. “You don’t get as much effective absorption with oral methotrexate” as can be achieved with subcutaneous injection of the drug, says Jonathan S. Coblyn, MD, Director of the Center for Arthritis and Joint Diseases at Brigham and Women’s Hospital in Boston. “The reason we may go to injectable methotrexate is that you may lose potency as you increase the dose.”

Dr. Fradlis

Dr. Fradlis

Bioavailability of oral methotrexate may be only two-thirds of what is absorbed when the drug is injected subcutaneously, says Dr. Fradlis.

“There have been several studies comparing oral and subcutaneous methotrexate throughout recent years. Some have shown that clinical responses are significantly better in patients who are given subcutaneous methotrexate as compared to oral methotrexate,” she says. A 2008 study published in Arthritis & Rheumatism showed that 80% of patients taking subcutaneous methotrexate achieved an ACR20 response compared with 60% who took oral methotrexate.1

Patients may experience injection site reactions, such as redness, swelling and pain, so they should alternate injection sites to minimize this risk, she says.

Higher Price Tag

Do RA patients need auto-injection devices for their methotrexate? Dr. Coblyn acknowledges the new products may be more convenient, but unnecessary. He has prescribed injectable methotrexate for some RA patients who don’t find effective absorption with the oral disease-modifying anti-rheumatic drug (DMARD), and shows them how to draw the drug from vials with syringes they buy in bulk. “I have never had a problem with the drug in that form. We show them how to do it, and it’s easy.”

Pages: 1 2 | Single Page

Filed Under: Conditions, Rheumatoid Arthritis Tagged With: auto-injectable methotrexate, Clinical, Diagnosis, Methotrexate, patient care, RA, Rheumatoid arthritis, rheumatologist, TreatmentIssue: October 2015

You Might Also Like:
  • Effectiveness of Tofacitinib with Methotrexate, Adalimumab Therapy Evaluated in Patients with RA
  • Researchers Find Rheumatologists Are Prescribing Methotrexate Less Often to Treat RA
  • Decernotinib, Subcutaneous Methotrexate Drug Updates, Trials, Approvals
  • Where Will Kinase Inhibitors Fit into the RA Treatment Mix?

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2022 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)