Needles Not Needed for Arthritis Drug

Juvenile arthritis patients benefit equally from oral methotrexate or injection

(RxWiki News) Many parents know this scenario: the nurse at the doctor's office pulls out a needle and your child starts bawling. For many children, shots are scary. Now it seems some kids with arthritis don't have to face the needle.

Oral methotrexate - a disease-modifying anti-rheumatic drug (DMARD) sold as Rheumatrex and Trexall - appears to be just as safe and effective as an injection of the drug in children with juvenile rheumatoid arthritis.

"Ask your child's doctor about easy-to-take drug options."

Methotrexate is used commonly as a first line treatment against juvenile arthritis, one of the most common inflammatory diseases in children. Past studies have shown methotrexate to be both safe and effective.

There are still some obstacles, such as the side effects of nausea and vomiting, that may limit the drug's use in children. The way the drug is delivered also may drive patients away from the drug.

In a recent study, Dr. Ariane Klein, of Asklepios Klinik Sankt Augustin in Germany, and colleagues compared the effectiveness and side effects between oral methotrexate and injectable methotrexate in children with juvenile arthritis.

The drug had similar effects, regardless of the delivery method.

After six months of treatment, 72 percent of patients receiving oral methotrexate had a clinical response, compared to 73 percent of patients receiving injection.

At least one negative side effect was seen in 22 percent of patients on the oral drug and 27 percent of patients on the injectable drug.

The results also show that more patients receiving injections quit treatment because of side effects compared to those taking the oral medication. While five percent of patients on oral methotrexate stopped treatment, 11 percent of those receiving injection quit due to side effects.

These findings suggest that both oral methotrexate and injection can be used to treat patients with juvenile arthritis. Since many kids do not like needles, these findings also may suggest that injectable methotrexate may be unnecessary in the treatment of juvenile arthritis.

According to Dr. Klein, "Our analysis found that efficacy and tolerability of [methotrexate] was similar in both delivery methods. The often unpopular [methotrexate] injection did not appear to be superior to oral administration and may likely be spared without clinical consequences."

The authors recommend that further research should explore the best delivery method for methotrexate treatment in juvenile arthritis patients.

The study, which included 411 patients receiving either oral methotrexate or injection, was published in the journal Arthritis Care & Research.

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Review Date: 
May 30, 2012