Prevalence of methotrexate intolerance in rheumatoid arthritis and psoriatic arthritis

Arthritis Research & Therapy
Maja Bulatović ĆalasanNico M Wulffraat

Abstract

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). 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. 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). 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 time...Continue Reading

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Citations

Jan 21, 2017·Inflammatory Bowel Diseases·Claire Dupont-LucasColette Deslandres
Jul 17, 2016·The Journal of Rheumatology·Barry J SheaneVinod Chandran
Jul 18, 2019·Biological Trace Element Research·Maria Fernanda Hornos CarneiroFernando Barbosa
Apr 8, 2020·Rheumatology·Boris Hügle, E H Pieter van Dijkhuizen
Sep 16, 2019·Clinical Rheumatology·Amit SandhuArchana Bhatnagar
Feb 9, 2020·Pediatric Rheumatology Online Journal·Rosanne M SmitsAndrea W M Evers
Sep 29, 2020·Open Access Rheumatology : Research and Reviews·Haya AlmalagMohammed A Omair
May 27, 2014·Expert Review of Clinical Immunology·Maja Bulatović Ćalasan, Nico M Wulffraat
Jun 21, 2017·Pediatric Rheumatology Online Journal·Sonja FalveyTimothy Beukelman
May 9, 2019·Zeitschrift für Rheumatologie·B Hügle
Feb 9, 2017·Inflammopharmacology·Mohammad A Y AlqudahBayan Ababneh
Aug 28, 2020·Journal of Ophthalmology·Ge Wang, Xiaoyan Peng
Mar 6, 2021·Reumatología clinica·Teresa OtónJose Luis Andreu
Jul 5, 2021·Clinical Rheumatology·Ummusen Kaya AkcaYelda Bilginer
Jul 25, 2021·Scientific Reports·Carlos Sánchez-PiedraFederico Díaz-González
Aug 26, 2021·International Journal of Rheumatic Diseases·Deeksha VijaykumarSanjay Jain
Dec 4, 2019·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Jéssica Martins AmaralAdriana Maria Kakehasi
Sep 29, 2021·Orthopaedic Nursing·Elizabeth SaltJean Edward
Dec 27, 2019·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Ronald Man Lung Yip, Cheuk Wan Yim

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ISRCTN13524271

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