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

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