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Methotrexate negatively affected QoL in majority of children with JIA
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A significant proportion of children with juvenile idiopathic arthritis had difficulties with their methotrexate regimens that adversely affected their health-related quality of life, according to recent study results.
One hundred seventy-one mothers of children with juvenile idiopathic arthritis (JIA; mean age, 9 years; 71.9% female) who were taking methotrexate (MTX) participated in the London-based study. They answered a study-designed questionnaire about MTX, two questions to assess needle-related issues from the treatment subscale of the Pediatric Quality of Life Inventory Rheumatology scale and the Child Health Questionnaire 50-item parent version (CHQ-PF50) to rate health-related quality of life (HRQoL).
Mothers reported that more than half of children experienced one or more of the following symptoms:
- Nausea or vomiting after taking MTX
- Anticipatory nausea
- Fear of blood tests or injections
MTX responders (ACR70 response or better), partial responders (ACR30 or ACR50) and nonresponders displayed no significant difference in reported rates of sickness or needle-related problems. Younger age (anxious about blood tests, adjusted exposure 0.76; 95% CI, 0.65-0.89; anxious about injections, adj. exp. 0.83; 95% CI, 0.73-0.95), taking MTX subcutaneously (vomiting afterward, adj. exp. 3.75; 95% CI, 1.28-11.06; anxious about injections, adj. exp. 2.31; 95% CI, 1.02-5.22) and having a larger number of currently active joints (feeling ill before MTX, adj. exp. 1.29; 95% CI, 1.05-1.60; anxious about injections, adj. exp. 1.40; 95% CI, 1.09-1.79) independently and significantly predicted MTX-related adverse events, based on multivariate analysis.
“Our study suggests that difficulties in taking MTX for children with JIA are common, and not explained simply by the child’s clinical response to medication,” the researchers concluded. “These difficulties can have an adverse effect on the child’s HRQoL, and approaches to help minimize and overcome them are required.”
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