Evidence map›Paper›PMID 35672619›Full record

SynthesisClinical rheumatology2022

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.

Fang Wang, Jingliang Tang, Zhe Li, Yanyan Qi, Ganpeng Li, Fang Wang

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Clinical rheumatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. 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 · 2026
    Guideline
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Fang Wang *Department of Rheumatology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China.
Jingliang Tang *School of Ethnic Medicine, State Ethnic Affairs Commission & Ministry of Education, Key Laboratory of Chemistry in Ethnic Medicinal Resources, Yunnan Minzu University, Kunming, 650500, Yunnan, People's Republic of China. 201562008240@sdu.edu.cn.
Zhe LiDepartment of Neonatology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250100, People's Republic of China.
Yanyan QiSchool of Ethnic Medicine, State Ethnic Affairs Commission & Ministry of Education, Key Laboratory of Chemistry in Ethnic Medicinal Resources, Yunnan Minzu University, Kunming, 650500, Yunnan, People's Republic of China.
Ganpeng LiSchool of Ethnic Medicine, State Ethnic Affairs Commission & Ministry of Education, Key Laboratory of Chemistry in Ethnic Medicinal Resources, Yunnan Minzu University, Kunming, 650500, Yunnan, People's Republic of China.
Fang WangSchool of Ethnic Medicine, State Ethnic Affairs Commission & Ministry of Education, Key Laboratory of Chemistry in Ethnic Medicinal Resources, Yunnan Minzu University, Kunming, 650500, Yunnan, People's Republic of China. 583234374@qq.com.ORCID http://orcid.org/0000-0002-8625-5914

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe most optimal route of methotrexate (MTX) administration for the treatment of rheumatoid arthritis (RA) has not yet been established. Our aim was to compare the efficacy, safety, and bioavailability profiles of oral MTX with parenteral MTX in adult patients with RA.

methodsPubMed, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalKey were searched for published randomized trials through December 30, 2021. Random-effects models were used to assess pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (95% CIs). This review was registered in PROSPERO (number CRD42022297810).

resultsOf 705 identified trials, 6 met the criteria and were included in our meta-analysis (644 subjects). Compared to parenteral MTX, oral MTX yielded no significant differences in response rates of 20% (OR: 0.68; 95% CI: 0.40-1.75), 50% (OR: 0.75; 95% CI: 0.44-1.28), and 70% (OR: 0.75; 95% CI: 0.51-1.09) improvement according to American College of Rheumatology criteria (ACR20/50/70 response), and no increased relative risk of any adverse event (OR: 1.20; 95% CI: 0.49-2.93). Furthermore, parenteral MTX showed a significant advantage in the value of AUC

conclusionOral MTX at doses of 15-25 mg/week in active RA is not inferior to parenteral regarding efficacy and safety. This supports the initial therapy with oral MTX.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidAdministration, OralAdultDrug Therapy, CombinationHumansMethotrexateTreatment OutcomeAntirheumatic AgentsMethotrexateMethotrexateOral administrationParenteral administrationRheumatoid arthritis

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.