OBJECTIVES: @entity1499 ( @entity6822 ) is considered the 'anchor drug' in the therapy of @entity309 ( @entity309 ), yet many physicians do not optimise @entity6822 regimens in spite of high @entity309 disease activity. The recent development of an auto-injector for the subcutaneous (subQ) administration of @entity6822 has prompted re-evaluation of @entity6822 utilisation. The purpose of this systematic literature review is to determine the optimal dose, drug level, and route of administration for @entity6822 in the context of relevant pharmacokinetics and pharmacogenomics. METHODS: A systematic literature review was performed in Medline searching specifically for randomised controlled trials, systematic reviews, case control and cohort studies evaluating outcomes related to @entity6822 dose and route of administration. Articles fulfilling these inclusion criteria were reviewed. Data on @entity6822 dose, route of administration, clinical response, drug levels and adverse events were evaluated. RESULTS: Our search identified 420 articles of which 6 were eligible for inclusion using the above criteria. These included 2 systematic reviews, 2 randomised open label trials, one longitudinal study and one retrospective cohort study. CONCLUSIONS: Efficacy and @entity137 for @entity6822 appear related to absorbed dose of @entity6822 , not to route of administration. While bioavailability is greater for parenteral @entity6822 , there is no evidence yet that splitting the oral dose of @entity6822 is less advantageous, less safe or less tolerable than administering parenteral @entity6822 . However, there appear to be modest benefits in beginning with higher doses of @entity6822 , and switching to parenteral @entity6822 when the clinical response to an oral dose is inadequate.

Outcomes related to XXXX dose and route of administration in patients with @entity309 : a systematic literature review.

@entity6822 :: ('D008727', 'Chemical') :: ['MTX'] @entity1499 :: ('MESH:D008727', 'Chemical') :: ['Methotrexate'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity309 :: ('MESH:D001172', 'Disease') :: ['rheumatoid arthritis', 'RA']
@entity1499 :: (MESH:D008727,Chemical) :: ['methotrexate']
