Patterns and Factors Influencing Methotrexate Discontinuation and Resumption in Rheumatoid and Psoriatic Arthritis: A Retrospective Observational Study

Background Methotrexate (MTX) is a first-line therapy for rheumatoid arthritis (RA) and widely used in psoriatic arthritis (PsA). Therapy is often interrupted due to adverse events, comorbidities and patient or disease-related factors. This study evaluated patterns, reasons, and outcomes of MTX discontinuation and resumption in routine practice.MethodsThis single-center, retrospective study reviewed medical records of 100 adults (50 RA, 50 PsA) who received oral MTX between 2015 and 2023. MTX discontinuation was defined as therapy cessation or a gap >60 days and resumption as any reinitiation post-discontinuation. Successful resumption required continuation for ≥3 months with documented disease stability or improvement, with or without dose adjustment. Associations were analyzed using χ², t-tests, Mann–Whitney U, and trend analyses, with p