LETTER TO THE EDITOR Subcutaneous (SC) Methotrexate (MTX) is Better and Well-Tolerable than Oral MTX in Rheumatoid Arthritis Patients, Switched from Oral to SC Administration Due to Gastrointestinal Side Effects.

Methotrexate (MTX) is an anchor drug in the treatment of patients with rheumatoid arthritis (RA) and is the preferred first line agent for this condition. It has a well established efficacy and safety profile but gastrointestinal (GI) side effects of oral route may restrict its use in most of the patients [1, 2]. Subcutaneous MTX is reported to be well tolerated and more effective even at higher doses than used orally [3, 4]. Subcutaneous form is suggested to be more expensive but it can impede the introduction of biologics and provide considerable savings [5, 6]. The aim of this study was to evaluate if subcutaneous MTX was more effective in our group of patients with RA, previously received oral MTX and switched to subcutaneous MTX, due to GI side effects.