The unsung hero of the RA revolution
Rheumatoid arthritis has undergone a paradigm shift over the past two decades - and it's not entirely down to biologics.
A review of six years of articles in major rheumatology journals reveals a big driver of better disease control has been higher doses of methotrexate (MTX).
The drug is now given at a mean dose of 20-25mg a week, and many clinicians give parenteral MTX to get doses up.
"When I was a registrar, methotrexate doses were 5 to 7.5 milligrams