Eisai Co., Ltd.

nippon medac Co., Ltd


Eisai Co., Ltd. (Headquarters: Tokyo, CEO: Haruo Naito, “Eisai”) and nippon medac Co., Ltd. (Headquarters: Tokyo, Representative Director and President: Hirohisa Iriyama, “nippon medac”), a subsidiary of medac Gesellschaft für klinische Spezialpräparate mbH (Headquarters: Germany, “medac GmbH”) announced today that they have launched the anti-rheumatic agent “Metoject® Subcutaneous Injection 7.5mg syringe 0.15mL, 10mg syringe 0.20mL, 12.5mg syringe 0.25mL and 15mg syringe 0.30mL” (methotrexate, “MTX”) in Japan with the indication of rheumatoid arthritis. nippon medac obtained the manufacturing and marketing approval of Japan’s first self-administrable subcutaneous injection formulation of MTX, a first line option for the treatment of rheumatoid arthritis, on September 26, 2022. The product is published to Japan’s National Health Insurance Drug Price List, today.


The approval of Metoject in Japan is based on the results of a Phase III clinical trial (MC-MTX.17/RA) conducted in Japan by nippon medac to compare the efficacy and safety of Metoject with that of oral MTX, which consisted of a double-blind phase and an extension phase. Based on the license agreement signed by Eisai and medac GmbH in May 2019, nippon medac will hold the marketing authorization of Metoject, while Eisai will be responsible for product distribution of Metoject in Japan.


“Eisai has established a solid franchise and has extensive sales experience in the rheumatoid arthritis area in Japan. By adding Metoject to Eisai's product lineup, we are now able to contribute to rheumatoid arthritis patients in a wide range of stages from the early stages of treatment,” said Terushige Iike, Senior Vice President of Eisai and President of Eisai Japan. “We are committed to making further contributions to address the diversified needs of, and increase the benefits provided to, rheumatoid arthritis patients.”


“Metoject is the first drug for which nippon medac obtained its manufacturing and marketing approval in Japan. It is also the first self-administrable MTX subcutaneous injection formulation for rheumatoid arthritis in Japan,” said Hirohisa Iriyama, Representative Director and President of nippon medac. “Although the drug is already widely used overseas, Eisai, which has extensive experience in this area, has been entrusted with the marketing of the drug in Japan, where there are an estimated 700,000 to 800,000 rheumatoid arthritis patients1, allowing us to bring the drug to them as a new treatment option. Nippon medac will continue to make further contributions in this area.”


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[Notes to editors]


  1. 1.Product Information

1)  Brand name
Metoject® Subcutaneous Injection 7.5mg syringe 0.15mL, 10mg syringe 0.20mL, 12.5mg syringe 0.25mL and 15mg syringe 0.30mL

2)  Generic name

3)  Indications
Rheumatoid arthritis

4)  Dosage and Administration
The usual adult dose of methotrexate is 7.5mg injected subcutaneously once a week. The dose may be increased depending on the condition, tolerability, etc. of the patient, but the maximum dosage must not exceed 15 mg.

5)  National Health Insurance (NHI) Drug Price
Metoject Subcutaneous Injection 7.5mg syringe 0.15mL     1,797 JPY/syringe

                                                      10mg syringe 0.20mL      2,189 JPY/syringe

                                                      12.5mg syringe 0.25mL   2,551 JPY/syringe

                                                      15mg syringe 0.30mL      2,890 JPY/syringe

6)  Packaging
Metoject Subcutaneous Injection 7.5mg syringe 0.15mL     1 syringe

                                                      10mg syringe 0.20mL      1 syringe

                                                      12.5mg syringe 0.25mL   1 syringe

                                                      15mg syringe 0.30mL      1 syringe


  1. 2.About Metoject Subcutaneous Injection Syringe (methotrexate)

Methotrexate (MTX) is positioned as the anchor drug for rheumatoid arthritis treatment.2 For rheumatoid arthritis, it is believed that MTX regulates cell growth by inhibiting folate metabolism in lymphocytes and other cells, and also has an anti-inflammatory mechanism through the promotion of adenosine synthesis in vascular endothelial cells and other cells in synovial membranes. Metoject will be the first self-administrable MTX subcutaneous injection formulation for rheumatoid arthritis in Japan. It is approved in approximately 50 countries, primarily in Europe.


  1. 3.About the Phase III Clinical Trial (MC-MTX.17/RA)

In the double-blind phase of the domestic Phase III clinical trial (MC-MTX.17/RA), 102 patients with rheumatoid arthritis who had not been treated with MTX, were administered 7.5 mg/week of Metoject or 8 mg/week of oral MTX repeatedly for 12 weeks. The primary endpoint of ACR20* response at 12 weeks was 59.6% (31/52 patients) in the Metoject group versus 51.0% (25/49 patients) in the oral MTX group, indicating comparable efficacy. The adverse drug reaction incidence rates in the double-blind phase of this trial were 25.0% (13/52 patients) in the Metoject group and 34.0% (17/50 patients) in the oral MTX group. The most common adverse drug reactions (incidence 5% and higher) were stomatitis at 5.8% (3/52 patients) in the Metoject group, and nausea at 12.0% (6/50 patients) and stomatitis at 6.0% (3/50 patients) in the oral MTX group.

In the extension phase, Metoject at a maximum dose of 15 mg was administered for 52 weeks in a total of 109 patients, including 98 patients who were transferred from the double-blind phase (50 patients from the Metoject group and 48 patients from the oral group) and 11 additional patients previously treated with 8 mg of oral MTX. The maximum doses of 7.5 mg, 10 mg and 12.5 mg, and 15 mg were used in 7.3%, 12.8%, 12.8% and 67.0% of patients, respectively. The adverse drug reaction incidence rate in the extension phase was 54.1% (59/109 patients). The most common adverse drug reactions (incidence 5% and higher) were nausea at 13.8% (15/109 patients), stomatitis at 11.9% (13/109 patients), increased alanine aminotransferase at 9.2% (10/109 patients), and decreased white blood cell count and abnormal liver function both at 8.3% (9/109 patients). In patients who were in the Metoject group during the double-blind phase, ACR20, ACR50 and ACR70 response at 64 weeks was 59.6% (31/52 patients), 51.9% (27/52 patients), and 42.3% (22/52 patients), respectively.

* ACR20 is a criterion developed by the American College of Rheumatology that measures improvement in clinical symptoms of rheumatoid arthritis. It expresses the percentage of patients who demonstrated a 20% or greater improvement in tender and swollen joint counts and at least three of the following five disease activity variables: patient assessment of pain; patient assessment of global disease activity; physician assessment of global disease activity; patient assessment of physical function; and chronic response protein or erythrocyte sedimentation rate concentrations.


  1. 4.About Eisai

Eisai’s Corporate Concept is “to give first thought to patients and people in the daily living domain, and to increase the benefits that health care provides.” Under this Concept (also known as our human health care (hhc) Concept), we aim to effectively achieve social good in the form of relieving anxiety over health and reducing health disparities. With a global network of R&D facilities, manufacturing sites and marketing subsidiaries, we strive to create and deliver innovative products to target diseases with high unmet medical needs, with a particular focus in our strategic areas of Neurology and Oncology.

In addition, our continued commitment to the elimination of neglected tropical diseases (NTDs), which is a target (3.3) of the United Nations Sustainable Development Goals (SDGs), is demonstrated by our work on various activities together with global partners.

For more information about Eisai, please visit (for global headquarters: Eisai Co., Ltd.), and connect with us on Twitter @Eisai_SDGs


  1. 5.About nippon medac

nippon medac Co., Ltd. was established in April 2016 as the Japanese subsidiary of medac GmbH. We are working to develop new drugs that can expand treatment options for diseases for which medical needs have not yet been fully met. We will work diligently to deliver quality drugs as quickly as possible to improve the quality of life of patients and their families in areas with high medical needs.


1 Report from Study Committee on Rheumatoid Arthritis and Allergy

2 Japan College of Rheumatology, Clinical practice guideline of methotrexate for patients with rheumatoid arthritis: 2016 update version