SynthesisPloS one2019
Comparison of oral versus parenteral methotrexate in the treatment of rheumatoid arthritis: A meta-analysis.
Synthesis in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05353829 (Efficacy, Tolerability and Preferences of Per Oral or Subcutaneous Methotrexate in Patients with Early Rheumatoid Arthritis - a Randomised Register Based Multicentre Study), which is not on this map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy, Tolerability and Preferences of Per Oral or Subcutaneous Methotrexate in Patients with Early Rheumatoid Arthritis - a Randomised Register Based Multicentre Study
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- S3 Guideline for the treatment of psoriasis vulgaris, adapted from EuroGuiDerm - part 1: Treatment recommendations and monitoring.Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG · 2026Guideline
- Subcutaneous methotrexate compared with oral methotrexate in rheumatoid arthritis: a systematic review and meta-analysis.Frontiers in immunology · 2026Pooled it
- Oral methotrexate at doses 15-25 mg/week is non-inferior to parenteral regarding efficacy and safety in the treatment of rheumatoid arthritis: a systematic review and meta-analysis.Clinical rheumatology · 2022Pooled it
- Split vs single-dose oral methotrexate in rheumatoid arthritis: a randomized controlled trial (SMART study).Clinical rheumatology · 2025Trial
- Attitudes of healthcare professionals towards the use of parenteral methotrexate in rheumatoid arthritis patients: a qualitative study.International journal of clinical pharmacy · 2026Article
- Real-world epidemiology and management of patients with rheumatoid arthritis treated with methotrexate in France: a decade after methotrexate first recommendations.EULAR rheumatology open · 2026Article
- Article
- Cost-Utility Analysis of Subcutaneous Methotrexate in the Treatment of Patients with Rheumatoid Arthritis in the UK.Advances in therapy · 2026Article
- Article
- Methotrexate in the management of Crohn's disease: A practice survey of gastroenterologists in France.World journal of gastroenterology · 2025Article
- Article
- Methotrexate in rheumatoid arthritis - ongoing debate about dosage and route of administration.Reumatologia · 2025Article
- Methotrexate treatment strategies for rheumatoid arthritis: a scoping review on doses and administration routes.BMC rheumatology · 2024Article
- International Survey to Evaluate Current Options for Subcutaneous Injection of Methotrexate (MTX) and a New Button-Free MTX Autoinjector.Patient preference and adherence · 2024Article
- Oral Versus Subcutaneous Methotrexate in Immune-Mediated Inflammatory Disorders: an Update of the Current Literature.Current rheumatology reports · 2023Review
- Difficult to treat psoriatic arthritis - how should we manage?Clinical rheumatology · 2023Review
- Difficult-to-treat rheumatoid arthritis (D2T RA): clinical issues at early stages of disease.RMD open · 2023Article
- Article
- Methotrexate; a trustworthy answer to an inflammatory response in osteoarthritis.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2022Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
Abstract
objectiveStudies suggest that parenteral MTX may be more efficacious than the oral form at equivalent doses for the treatment of rheumatoid arthritis. We carried out a meta-analysis to compare the efficacy of oral versus parenteral MTX in RA.
methodsPubMed, Web of Science and Embase were systematically searched from inception to June 8th 2017 and reviewed following PRISMA 2009 guidelines, by two independent reviewers. To be included, trials had to study adults with RA randomized to the same dose of either oral or parenteral MTX. The primary endpoint was ACR20 at 6 months. Intention-to-treat analysis results were used when possible. Data from direct comparisons between oral and parenteral methotrexate quantitatively analyzed using maximum likelihood random effects meta-analysis. Relative treatment effects were generated as an odds ratio [OR] (OR>1 indicated a benefit for parenteral therapy).
resultsThe search yielded 357 papers or abstracts. After review of titles or abstracts and full text papers, we found 4 that met inclusion criteria with 703 patients randomized. Dose of MTX started at 15mg/week and increased up to 25mg/week. The summary OR for achieving ACR20 using parenteral vs. oral MTX was 3.02 (95% CI 1.41, 6.46), with no significant difference in the risk for all adverse events.
conclusionParenteral MTX therapy had significantly higher odds than oral MTX of achieving reduction in disease activity. We propose that parenteral MTX is more effective than weekly oral MTX; its widespread use may lead to better control of disease and a decrease in demand for biologic agents.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.