TY - JOUR
T1 - Prevalence of methotrexate intolerance in rheumatoid arthritis and psoriatic arthritis
AU - Bulatović Ćalasan, Maja
AU - van den Bosch, Oscar F.C.
AU - Creemers, Marjonne C.W.
AU - Custers, Martijn
AU - Heurkens, Antonius H.M.
AU - van Woerkom, Jan M.
AU - Wulffraat, Nico M.
PY - 2013
Y1 - 2013
N2 - INTRODUCTION: The aim of this study was to determine the prevalence of gastrointestinal and behavioural symptoms occurring before (anticipatory/associative) and after methotrexate (MTX) administration, termed MTX intolerance, in rheumatoid (RA) and psoriatic arthritis (PsA).METHODS: Methotrexate Intolerance Severity Score (MISS), previously validated in juvenile idiopathic arthritis patients, was used to determine MTX intolerance prevalence in 291 RA/PsA patients. The MISS consisted of four domains: abdominal pain, nausea, vomiting and behavioural symptoms, occurring upon, prior to (anticipatory) and when thinking of MTX (associative). MTX intolerance was defined as ≥6 on the MISS with ≥1 point on anticipatory and/or associative and/or behavioural items.RESULTS: A total of 123 patients (42.3%) experienced at least one gastrointestinal adverse effect. The prevalence of MTX intolerance was 11%. MTX intolerance prevalence was higher in patients on parenteral (20.6%) than on oral MTX (6.2%) (p < 0.001).CONCLUSION: Besides well-known gastrointestinal symptoms after MTX, RA and PsA patients experienced these symptoms also before MTX intake. RA and PsA patients on MTX should be closely monitored with the MISS for early detection of MTX intolerance, in order to intervene timely and avoid discontinuation of an effective treatment.
AB - INTRODUCTION: The aim of this study was to determine the prevalence of gastrointestinal and behavioural symptoms occurring before (anticipatory/associative) and after methotrexate (MTX) administration, termed MTX intolerance, in rheumatoid (RA) and psoriatic arthritis (PsA).METHODS: Methotrexate Intolerance Severity Score (MISS), previously validated in juvenile idiopathic arthritis patients, was used to determine MTX intolerance prevalence in 291 RA/PsA patients. The MISS consisted of four domains: abdominal pain, nausea, vomiting and behavioural symptoms, occurring upon, prior to (anticipatory) and when thinking of MTX (associative). MTX intolerance was defined as ≥6 on the MISS with ≥1 point on anticipatory and/or associative and/or behavioural items.RESULTS: A total of 123 patients (42.3%) experienced at least one gastrointestinal adverse effect. The prevalence of MTX intolerance was 11%. MTX intolerance prevalence was higher in patients on parenteral (20.6%) than on oral MTX (6.2%) (p < 0.001).CONCLUSION: Besides well-known gastrointestinal symptoms after MTX, RA and PsA patients experienced these symptoms also before MTX intake. RA and PsA patients on MTX should be closely monitored with the MISS for early detection of MTX intolerance, in order to intervene timely and avoid discontinuation of an effective treatment.
KW - Anti-Inflammatory Agents/adverse effects
KW - Arthritis, Psoriatic/drug therapy
KW - Arthritis, Rheumatoid/drug therapy
KW - Cross-Sectional Studies
KW - Female
KW - Gastrointestinal Diseases/chemically induced
KW - Humans
KW - Male
KW - Methotrexate/adverse effects
KW - Middle Aged
KW - Prevalence
UR - http://www.scopus.com/inward/record.url?scp=84891555722&partnerID=8YFLogxK
U2 - 10.1186/ar4413
DO - 10.1186/ar4413
M3 - Article
C2 - 24345416
AN - SCOPUS:84891555722
SN - 1478-6354
VL - 15
JO - Arthritis Research & Therapy
JF - Arthritis Research & Therapy
IS - 6
M1 - R217
ER -