What are some of the myths about methotrexate?

The myth: There’s no difference between oral and subcutaneous methotrexate.

The reality: There are a few differences between these two forms of methotrexate, actually. The subcutaneous form delivers more methotrexate into the blood. That is why studies have shown it is more effective than the oral form when it comes to controlling rheumatoid arthritis (RA) symptoms. And for many people, subcutaneous methotrexate is easier on the stomach than the pill form.

The myth: Methotrexate takes too long to work.

The reality: Most patients begin to feel symptom relief between 3 and 6 weeks, and studies have shown that patients had significant symptom improvement within 3 months of treatment. Patients may continue to improve for up to 1 year, with relief sustained even longer.

The myth: Methotrexate is chemotherapy and poisons the body.

The reality: It’s true that methotrexate has been used effectively to treat many different cancers. However, the doses used in cancer treatment are much higher than those used in RA. For example, the dose used in RA is typically no more than 25 mg/week, whereas doses for cancer can range from 15 mg/day up to 175 mg/week.

The myth: Methotrexate doesn’t work as well as biologic therapy.

The reality: Actually, multiple studies have shown that in approximately 30% of patients with RA, methotrexate taken alone was effective for controlling symptoms.

The myth: Methotrexate doesn’t slow or stop the progression of RA.

The reality: Several studies that followed patients for at least 3 years have shown that methotrexate slowed or stopped disease progression as well as biologic therapy did in 60% to 70% of patients.