Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

99 questions · 100 findings · 9 reviews · Musculoskeletal

No studies found 22 · 22%GRADE not reported 0 · 0%Very low 9 · 9%Low 27 · 27%Moderate 36 · 36%High 6 · 6%

Oral methotrexate plus intra‐articular glucocorticoid vs intra‐articular glucocorticoid alone

Sustained clinically inactive diseasec · children and young people with JIA

Oral methotrexate plus intra‐articular glucocorticoid showed no clear difference in sustained clinically inactive diseaseb(12 months) compared with intra‐articular glucocorticoid alone (low certainty).

1 finding from 1 review

Oral methotrexate plus intra‐articular glucocorticoid vs intra‐articular glucocorticoid alone

Withdrawals due to adverse events · children and young people with JIA

Oral methotrexate plus intra‐articular glucocorticoid showed no clear difference in withdrawals due to adverse events(12 months) compared with intra‐articular glucocorticoid alone (low certainty).

1 finding from 1 review

Folic or folinic acid (any) vs placebo

Gastrointestinal adverse events · Patients receiving methotrexate for rheumatoid arthritis

Folic or folinic acid (any) probably leads to lower GI side effects (nausea, vomiting, abdominal pain) compared with placebo (moderate certainty).

1 finding from 1 review

Summary of findings: Folic acid vs placebo

Liver toxicity (incidence of transaminase elevation) · Patients receiving methotrexate for rheumatoid arthritis

Folic acid probably leads to lower liver toxicity (ie, incidence of transaminase elevation) compared with placebo (moderate certainty).

1 finding from 1 review

Summary of findings: Folic acid vs placebo

Haematological disorders (neutropenia, etc) · Patients receiving methotrexate for rheumatoid arthritis

Folic acid showed no clear difference in haematological disorders (incidence of neutropenia, etc) compared with placebo (low certainty).

1 finding from 1 review