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Patient’s experience with subcutaneous and oral methotrexate for the treatment of rheumatoid arthritis

BACKGROUND: Despite the prominent position of methotrexate (MTX) in Rheumatoid Arthiris (RA) therapeutics, its real-world effectiveness may be influenced by a relative lack of tolerability or other side effects that physicians may not be aware of but that are bothersome to patients. The aim of this...

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Autores principales: Curtis, J. R., Xie, F., Mackey, D., Gerber, N., Bharat, A., Beukelman, T., Saag, K. G., Chen, L., Nowell, B., Ginsberg, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037591/
https://www.ncbi.nlm.nih.gov/pubmed/27669978
http://dx.doi.org/10.1186/s12891-016-1254-x
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author Curtis, J. R.
Xie, F.
Mackey, D.
Gerber, N.
Bharat, A.
Beukelman, T.
Saag, K. G.
Chen, L.
Nowell, B.
Ginsberg, S.
author_facet Curtis, J. R.
Xie, F.
Mackey, D.
Gerber, N.
Bharat, A.
Beukelman, T.
Saag, K. G.
Chen, L.
Nowell, B.
Ginsberg, S.
author_sort Curtis, J. R.
collection PubMed
description BACKGROUND: Despite the prominent position of methotrexate (MTX) in Rheumatoid Arthiris (RA) therapeutics, its real-world effectiveness may be influenced by a relative lack of tolerability or other side effects that physicians may not be aware of but that are bothersome to patients. The aim of this study is to identify suboptimal patient experience with MTX and to raise awareness for clinicians to identify opportunities to mitigate bothersome symptoms and side effects and optimize response to MTX. METHODS: We conducted a prospective, cross-sectional, online survey among RA patients who were members of Creakyjoints, a large arthritis patient community. Eligible participants must have recently initiated a new biologic, subcutaneous (SQ) MTX, or oral MTX in the last 12 months and were uniquely assigned to one of these 3 groups. Descriptive statistics were used to compare patient-reported side effects and tolerability related to MTX use in the 3 medication groups (SQ MTX, oral MTX, and biologic). RESULTS: A total of 382 (85 %) of 448 eligible patients completed the survey and were grouped as: biologic (n = 218), SQ MTX (n = 49), and oral MTX (n = 115). Demographics were mean standard deviation (SD) age 48 (10) years, 92 % white, 91 % women. Symptoms significantly more prevalent in the SQ and oral MTX groups included diarrhea, fatigue, malaise, and hair loss. Injection related pain was lower with SQ MTX compared to SQ biologics. Out of a total of 8 potential symptoms and side effects examined, higher dose MTX (> = 20 mg/week) was associated with a 2.26 (1.25–4.09) greater likelihood of more side effects referent to < =10 mg/week. CONCLUSION: Results from this real-world RA patient cohort suggest that MTX is accompanied by many patient-reported side effects and tolerability problems that may be under-recognized by physicians. These may impact both treatment satisfaction and medication adherence.
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spelling pubmed-50375912016-10-05 Patient’s experience with subcutaneous and oral methotrexate for the treatment of rheumatoid arthritis Curtis, J. R. Xie, F. Mackey, D. Gerber, N. Bharat, A. Beukelman, T. Saag, K. G. Chen, L. Nowell, B. Ginsberg, S. BMC Musculoskelet Disord Research Article BACKGROUND: Despite the prominent position of methotrexate (MTX) in Rheumatoid Arthiris (RA) therapeutics, its real-world effectiveness may be influenced by a relative lack of tolerability or other side effects that physicians may not be aware of but that are bothersome to patients. The aim of this study is to identify suboptimal patient experience with MTX and to raise awareness for clinicians to identify opportunities to mitigate bothersome symptoms and side effects and optimize response to MTX. METHODS: We conducted a prospective, cross-sectional, online survey among RA patients who were members of Creakyjoints, a large arthritis patient community. Eligible participants must have recently initiated a new biologic, subcutaneous (SQ) MTX, or oral MTX in the last 12 months and were uniquely assigned to one of these 3 groups. Descriptive statistics were used to compare patient-reported side effects and tolerability related to MTX use in the 3 medication groups (SQ MTX, oral MTX, and biologic). RESULTS: A total of 382 (85 %) of 448 eligible patients completed the survey and were grouped as: biologic (n = 218), SQ MTX (n = 49), and oral MTX (n = 115). Demographics were mean standard deviation (SD) age 48 (10) years, 92 % white, 91 % women. Symptoms significantly more prevalent in the SQ and oral MTX groups included diarrhea, fatigue, malaise, and hair loss. Injection related pain was lower with SQ MTX compared to SQ biologics. Out of a total of 8 potential symptoms and side effects examined, higher dose MTX (> = 20 mg/week) was associated with a 2.26 (1.25–4.09) greater likelihood of more side effects referent to < =10 mg/week. CONCLUSION: Results from this real-world RA patient cohort suggest that MTX is accompanied by many patient-reported side effects and tolerability problems that may be under-recognized by physicians. These may impact both treatment satisfaction and medication adherence. BioMed Central 2016-09-26 /pmc/articles/PMC5037591/ /pubmed/27669978 http://dx.doi.org/10.1186/s12891-016-1254-x Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Curtis, J. R.
Xie, F.
Mackey, D.
Gerber, N.
Bharat, A.
Beukelman, T.
Saag, K. G.
Chen, L.
Nowell, B.
Ginsberg, S.
Patient’s experience with subcutaneous and oral methotrexate for the treatment of rheumatoid arthritis
title Patient’s experience with subcutaneous and oral methotrexate for the treatment of rheumatoid arthritis
title_full Patient’s experience with subcutaneous and oral methotrexate for the treatment of rheumatoid arthritis
title_fullStr Patient’s experience with subcutaneous and oral methotrexate for the treatment of rheumatoid arthritis
title_full_unstemmed Patient’s experience with subcutaneous and oral methotrexate for the treatment of rheumatoid arthritis
title_short Patient’s experience with subcutaneous and oral methotrexate for the treatment of rheumatoid arthritis
title_sort patient’s experience with subcutaneous and oral methotrexate for the treatment of rheumatoid arthritis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037591/
https://www.ncbi.nlm.nih.gov/pubmed/27669978
http://dx.doi.org/10.1186/s12891-016-1254-x
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