Gastrointestinal symptoms in patients using methotrexate: A cross-sectional study in a sample with rheumatoid arthritis

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-01 DOI:10.1016/j.reuma.2024.03.006

Carina Albuquerque Roberto, Isabela Stachevski, Barbara Stadler Kahlow, Renato Nisihara, Thelma Skare

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引用次数: 0

Abstract

Background

Gastrointestinal intolerance is common in rheumatoid arthritis (RA) patients using methotrexate and may lead to treatment discontinuation.

Aim

To study the prevalence of gastrointestinal symptoms in a sample of RA methotrexate users as well as its possible association with clinical and epidemiological variables.

Methods

Cross-sectional study of 192 patients with gastrointestinal symptoms using the MISS (methotrexate intolerance severity score). Clinical and epidemiological variables were collected through chart review and direct questioning. Patients’ adherence to methotrexate was evaluated through Moriski–Green–Levin questionnaire.

Results

The prevalence of gastrointestinal complaints was high with 55.7% of the sample classified as intolerant. Nausea and pain after drug ingestion were the most common reported complaints. This intolerance was associated with afro-descendant background (p = 0.02); presence of associated fibromyalgia (p = 0.04), concomitant use of glucocorticoids (p = 0.03) and Jak inhibitors (0.03). A tendency towards association with leflunomide use was observed (p = 0.06). Logistic regression was used to test drug associations with methotrexate intolerance, and showed that glucocorticoid use was independently associated with methotrexate intolerance OR = 1.85; 95% CI = 1.01–3.44; p = 0.04. Route of administration, presence of previous gastric complaints, age and methotrexate dose did not interfere with MISS. MISS results were associated with moderate adherence to the drug.

Conclusions

There is a high rate of methotrexate intolerance that is more common in afro-descendants, those with associated fibromyalgia, glucocorticoid and Jak inhibitors users.

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使用甲氨蝶呤患者的胃肠道症状：一项针对类风湿性关节炎样本的横断面研究

背景胃肠道不耐受在使用甲氨蝶呤的类风湿性关节炎（RA）患者中很常见，可能会导致治疗中断。目的研究胃肠道症状在RA甲氨蝶呤使用者样本中的流行率及其与临床和流行病学变量的可能关联。通过病历审查和直接询问收集临床和流行病学变量。结果胃肠道不适的发生率很高，55.7%的样本被归类为不耐受。恶心和服药后疼痛是最常见的主诉。这种不耐受与非洲裔背景（p = 0.02）、伴有纤维肌痛（p = 0.04）、同时使用糖皮质激素（p = 0.03）和 Jak 抑制剂（0.03）有关。观察到与使用来氟米特相关的趋势（p = 0.06）。逻辑回归用于检验药物与甲氨蝶呤不耐受的相关性，结果显示使用糖皮质激素与甲氨蝶呤不耐受独立相关，OR = 1.85; 95% CI = 1.01-3.44; p = 0.04。给药途径、既往是否有胃部不适、年龄和甲氨蝶呤剂量均不影响 MISS。结论甲氨蝶呤不耐受的发生率很高，在非洲裔、伴有纤维肌痛、糖皮质激素和 Jak 抑制剂使用者中更为常见。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.