The effect of repeated methotrexate injections on the quality of life of children with rheumatic diseases

In clinical practice, the burden of repeated injections in children with rheumatic disease receiving disease-modifying anti-rheumatic drugs is significant. To investigate the nature and extent of impact on the quality of life after repeated injections, we conducted a literature review. Two relevant papers were identified, both about children with juvenile idiopathic arthritis (JIA) being administered methotrexate. The results suggest that the combination of needle fear, impact of methotrexate treatment, and procedural consequences, e.g., blood sampling, all contribute to the distress and the loss of quality of life of children with JIA. Remarkably, no studies examining fear of injections or injection pain in children with rheumatic diseases receiving biologicals were identified. Conclusion: Strategies to optimize administration of disease modifying anti-rheumatic drugs should be systematically investigated. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00431-018-3286-8) contains supplementary material, which is available to authorized users.