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August 7, 2026Rheumatology & autoimmunityOpen Access

Clinical predictors of response to methotrexate in patients with rheumatoid arthritis: A systematic review

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Authors

JRJoana RodriguesUniversity of Beira InteriorHDHelena DonatoHospitais da Universidade de CoimbraSASoraia AzevedoAdministração Regional de Saúde de Lisboa e Vale do Tejo

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Overview

Systematic review identifies predictors of methotrexate response in rheumatoid arthritis, suggesting personalized treatment strategies.

Key Points

  • This systematic review aims to identify predictors of methotrexate response in rheumatoid arthritis patients.
  • Conducted systematic search in PubMed/MEDLINE, Scopus, and CENTRAL until May 2024.
  • Included 87 studies: randomized controlled trials, prospective cohort studies, and registry-based studies.
  • Predicted factors categorized by demographics, disease, serology, genetics, treatment, and emerging areas.
  • Favorable MTX response linked to lower disease activity, better functional status, early MTX initiation, and no erosive disease.
  • Male sex, older age, and moderate alcohol use associated with improved outcomes, while smoking and higher BMI reduced efficacy.
  • Emerging biomarkers showed potential for early prediction of response, highlighting the need for integrated approaches.

Cite This Study

Rodrigues et al. (2026) studied this question.

synapsesocial.com/papers/6a758bd0847ab6d26c01f656https://doi.org/10.1002/rai2.70058
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Predictive Factors of Methotrexate Monotherapy Success in Patients with Rheumatoid Arthritis in a National Referral Center: A Cohort Study2024
  2. 2Development and validation of a clinical scoring system for the prediction of methotrexate treatment response in rheumatoid arthritis patients: a multicenter real-world study2026
  3. 3Precision medicine in rheumatoid arthritis: Evaluation of a new approach to predict clinical response to methotrexate in patients with early rheumatoid arthritis2025
  4. 4Genetic polymorphisms associated with therapeutic response and adverse effects to methotrexate in Taiwanese patients with rheumatoid arthritis: a real-world, hospital-based study2026
  5. 5Association of baseline serum cytokine profile with disease activity and methotrexate response in newly diagnosed rheumatoid arthritis2026