Published in:
Open Access
01-12-2013 | Research article
Prevalence of methotrexate intolerance in rheumatoid arthritis and psoriatic arthritis
Authors:
Maja Bulatović Ćalasan, Oscar FC van den Bosch, Marjonne CW Creemers, Martijn Custers, Antonius HM Heurkens, Jan Maarten van Woerkom, Nico M Wulffraat
Published in:
Arthritis Research & Therapy
|
Issue 6/2013
Login to get access
Abstract
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.