What are the indications of methotrexate (MTX) subcutaneous autoinjector (Otrexup) in rheumatoid arthritis (RA)?

Updated: Mar 05, 2021
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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n October 2013, the US Food and Drug Administration (FDA) approved the first single-dose, self-administered, disposable MTX subcutaneous autoinjector (Otrexup). [75] Otrexup is indicated for adults with severe, active RA who have either responded inadequately to or cannot tolerate first-line therapy, as well as for children with active polyarticular juvenile idiopathic arthritis (JIA) (also known as juvenile rheumatoid arthritis). [75]

In a meta-analysis of 158 trials, triple therapy (MTX, SSZ, and HCQ) was found to have a statistically significant benefit of inhibiting joint damage compared with oral MTX alone.  Also, there was no statistically significant difference in preventing joint damage between triple therapy and MTX in combination with a biologic (adalimumab, certolizumab, etancercept, or inflximab) or the combination of MTX and tofacitinib. [76]

The FDA also approved Otrexup to control symptoms in adults with severe, recalcitrant, disabling psoriasis if the disease has not adequately responded to other treatments. [75]

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