Methotrexate, rheumatoid arthritis and infection risk: what is the evidence?

Rheumatology (Oxford). 2009 Aug;48(8):867-71. doi: 10.1093/rheumatology/kep101. Epub 2009 May 15.


Low-dose MTX administered weekly remains a mainstay in the therapy of RA. There is a belief amongst rheumatologists that RA patients taking MTX have both an increased risk and severity of infection. Here we review the published data on the risks of infection associated with the use of MTX in patients with RA and make some recommendations for managing MTX in patients with infection.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents / adverse effects*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / immunology
  • Arthritis, Rheumatoid / microbiology
  • Bacterial Infections / immunology*
  • Comorbidity
  • Drug Administration Schedule
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Methotrexate / adverse effects*
  • Methotrexate / therapeutic use
  • Risk


  • Antirheumatic Agents
  • Immunosuppressive Agents
  • Methotrexate