Enhanced Rheumatoid Arthritis Response with Split-Dose Methotrexate Compared to Single Dose

20 Nov 2023 • Methotrexate (MTX), the anchor drug for rheumatoid arthritis (RA), has limited bioavailability above an oral dose of 15 mg. Split-dose oral MTX (morning, evening same day) has been shown to lead to higher blood levels compared to single-dose, however, its effect on clinical efficacy is unknown.

  • The American College of Rheumatology (ACR) 2023 Annual Meeting showcased that a weekly split-dose of oral methotrexate (MTX) in RA patients had significantly higher efficacy and reduced the need for additional DMARDs, compared to a single-dose of MTX given once a week.
  • Patients were randomized 1:1 and allocated into either single dose (25 mg) or split-dose (10 mg morning, 15 mg evening, same day) once weekly MTX for 24 weeks.
  • There were no major adverse events, but a slight increase in the frequency of persistent transaminitis was observed in the split-dose group.

Source: ACR Convergence 2023 | Read full story

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