Methotrexate Treatment Patterns in Advanced Therapy-Naïve Patients with Rheumatoid Arthritis: Clinical Characteristics and Outcomes of Patients in the Corrona Registry

In an observational study of 785 patients with rheumatoid arthritis (RA) from the US Corrona RA registry who initiated methotrexate (MTX) treatment between October 2001 and October 2018, 34 (4.3%) discontinued and restarted MTX, 174 (22.2%) discontinued without restarting, and 577 (73.5%) persisted with MTX over a 2-year follow-up period. The study found that patients who discontinued and restarted MTX had more comorbidities at initiation, experienced less improvement in disease activity, and suffered more side effects compared to those who persisted on MTX. Specifically, higher rates of hair loss (35.3% vs 18.9%), loss of appetite (32.4% vs 17.3%), stomach pain (26.5% vs 14.6%), mouth sores (20.6% vs 16.3%), diarrhea (11.8% vs 9.5%), and myelosuppression (8.8% vs 2.1%) were observed in patients who discontinued/restarted MTX versus those who persisted. Overall, more than 26% of patients either discontinued MTX permanently or temporarily within the two years after initiation.