OTREXUP™ (methotrexate) injection was recently approved by the U.S. Food and Drug Administration.
It is indicated for adults with severe, active rheumatoid arthritis, or children with active polyarticular juvenile idiopathic arthritis who have failed first line therapies. It is also indicated for severe, recalcitrant, disabling psoriasis.
[…]
The potential for hepatotoxicity is a well-recognized feature of therapy with a number of DMARDs in rheumatoid arthritis (RA), with methotrexate (MTX) being the most common utilized. Concomitant use of other hepatotoxic agents has the potential to compound the risk of significant liver damage. Among these, isoniazid (INH) is increasingly used in RA patients receiving MTX with evidence of latent tuberculosis infection (LTBI) or prior active tuberculosis for whom TNF inhibitor therapy is planned.
Patients with early inflammatory arthritis not meeting classification criteria for rheumatoid arthritis (RA) may have treatment delayed until typical phenotypic features accumulate. Due to the concern for toxicities of DMARDs, patients are often treated with NSAIDs and simple analgesics during this period. However, delay in DMARD treatment in early RA has been shown to result in poorer outcomes, such as irreversible radiographic damage.
