Recommendations for the use of methotrexate in rheumatoid arthritis: up and down scaling of the dose and administration routes.

Objectives: To describe the optimal therapeutic strategy for use of methotrexate in RA patients over the initial dose, route of administration, dose increase and decrease, patient monitoring, and use of folic/folinic acid.

Material And Method: Eleven clinical experts proposed some questions to be solved. A systematic literature search was conducted.