Patient’s Experience with Subcutaneous and Oral Methotrexate for the Treatment of Rheumatoid Arthritis

This study aimed to identify suboptimal patient experiences with methotrexate (MTX) in treating rheumatoid arthritis (RA) and raise clinician awareness of bothersome symptoms and side effects. A prospective, cross-sectional, online survey was conducted among 382 RA patients who recently initiated a new biologic, subcutaneous (SQ) MTX, or oral MTX. The survey revealed that symptoms such as diarrhea, fatigue, malaise, and hair loss were significantly more prevalent in the SQ and oral MTX groups. Higher doses of MTX (≥20 mg/week) were associated with a greater likelihood of side effects compared to lower doses (≤10 mg/week). The findings suggested that MTX is accompanied by many patient-reported side effects and tolerability issues that may be under-recognized by physicians, potentially impacting treatment satisfaction and medication adherence.