Rheumatology

Methotrexate

Questions discussed in this category

How do you approach managing nausea and GI side effects when initiating methotrexate?

3 Answers available

What is your approach to differentiating RA-ILD from medication toxicity (I.e. from methotrexate)?

1 Answer available

Do you combine methotrexate and leflunomide for the treatment of RA?

3 Answers available

What is the maximum dose of leucovorin that you use with methotrexate?

2 Answers available

Do you continue methotrexate in patients with inflammatory arthritis who develop non-melanomatous skin cancer while on therapy?

1 Answer available

Is there a role for the use of transient elastography (FibroScan) to monitor liver fibrosis in patients on long term methotrexate?

3 Answers available

How do you approach monitoring when using combination JAK inhibitors and methotrexate in RA?

1 Answer available

How do you approach methotrexate management around vaccines other than COVID and influenza?

Data is clear that we should hold methotrexate at least one week after COVID and flu vaccines. How do you approach methotrexate management around Shin...

1 Answer available

How often do you monitor labs in patients taking methotrexate?

4 Answers available

What is your approach to rheumatologic disease management during the current methotrexate shortage?

2 Answers available

Do you recommend patients continue folic acid for a few weeks after methotrexate discontinuation?

1 Answer available

How do you approach treatment of RA with methotrexate in a patient with treated Hepatitis C and normal liver function?

1 Answer available

In the absence of lung disease, do you prefer methotrexate or mycophenolate mofetil in the initial treatment of cutaneous-only manifestations in systemic sclerosis?

2 Answers available

How do you approach folate supplementation for methotrexate-related side effects?

3 Answers available

What is your methotrexate initiation strategy in DMARD-naive RA patients?

Specifically: starting dose, rapidity of up-titration, frequency of lab monitoring, frequency of office visits, and timing of assessment for treatment...

2 Answers available

What is your threshold for number of alcoholic drinks per week before reconsidering prescribing methotrexate/leflunomide?

1 Answer available

How would you manage methotrexate therapy in an active rheumatoid arthritis patient undergoing treatment for latent TB with rifampin?

Do you stop methotrexate or adjust the dose?

1 Answer available

How would you treat uveitis in a patient with a history of cutaneous T cell lymphoma?

Patient was previously well controlled on methotrexate, which was discontinued during cancer treatment.

1 Answer available

Should MTX be avoided in RA patients with asymptomatic lung nodules?

If so, what would be an ideal DMARD in this setting?

1 Answer available

Should tuberculosis screening be performed before beginning methotrexate for treatment of rheumatoid arthritis?

1 Answer available

How do you assess transaminitis in a patient with sarcoidosis with known liver involvement being treated with methotrexate?

1 Answer available

Should methotrexate be categorically avoided in RA patients with COPD or RA-ILD?

1 Answer available

Should patients be screened for hepatitis B/C prior to starting a conventional synthetic DMARD such as methotrexate?

1 Answer available

Papers discussed in this category

Semin. Arthritis Rheum., 2020 Mar 19

RISE registry reveals potential gaps in medication safety for new users of biologics and targeted synthetic DMARDs.

Archives of internal medicine, 2008-09-22

Methotrexate is not associated with progression of interstitial lung disease in rheumatoid arthritis.

Arthritis and rheumatism, 2010-06

Incidence and mortality of interstitial lung disease in rheumatoid arthritis: a population-based study.

Cochrane Database Syst Rev, 2013 May 31

Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis.

British journal of cancer, 2023 Feb 04

Use of methotrexate and risk of skin cancer: a nationwide case-control study.

Ann Rheum Dis, 2017 Mar 23

Quantifying the hepatotoxic risk of alcohol consumption in patients with rheumatoid arthritis taking methotrexate.

BMJ, 2023 May 30

Risk stratified monitoring for methotrexate toxicity in immune mediated inflammatory diseases: prognostic model development and validation using primary care data from the UK.

BMJ, 2023 May 30

Monitoring methotrexate toxicity: Are we being over-vigilant?

Ann Rheum Dis, 2021 Sep 07

Impact of disease-modifying antirheumatic drugs on vaccine immunogenicity in patients with inflammatory rheumatic and musculoskeletal diseases.

BMC public health, 2008 Jan 21

The SMILE study: a study of medical information and lifestyles in Eindhoven, the rationale and contents of a large prospective dynamic cohort study.

Arthritis & rheumatology (Hoboken, N.J.), 2017-03

Baricitinib, Methotrexate, or Combination in Patients With Rheumatoid Arthritis and No or Limited Prior Disease-Modifying Antirheumatic Drug Treatment.

Annals of the rheumatic diseases, 2019 Jul 30

Safety and effectiveness of upadacitinib or adalimumab plus methotrexate in patients with rheumatoid arthritis over 48 weeks with switch to alternate therapy in patients with insufficient response.

Arthritis and rheumatism, 1988-07

The effects of leucovorin (folinic acid) on methotrexate therapy in rheumatoid arthritis patients.

Arthritis and rheumatism, 1993-06

Low-dose methotrexate with leucovorin (folinic acid) in the management of rheumatoid arthritis. Results of a multicenter randomized, double-blind, placebo-controlled trial.

The Journal of rheumatology, 2014 Apr 15

Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis.

Rheumatol Int, 2021 Jan 29

Does methotrexate cause progressive fibrotic interstitial lung disease? A systematic review.

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