Fatigue, gastrointestinal issues top complaints among patients taking methotrexate
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ATLANTA — Fatigue and gastrointestinal complaints were the most common patient-reported adverse events associated with methotrexate among individuals with rheumatoid arthritis and psoriatic arthritis, according to a speaker at ACR/ARP 2019.
“We wanted to understand the patient experience of methotrexate in people with inflammatory arthritis,” W. Benjamin Nowell, PhD, director of Patient-Centered Research at CreakyJoints, told Healio Rheumatology. “Although it is almost always first-line therapy, it is also associated with a lot of events that make it intolerable for patients.”
Nowell and colleagues assessed data for 371 patients with RA and PsA from the ArthritisPower registry. The analysis included 172 current and 199 previous methotrexate users. Participants completed an online survey asking a cross-section of questions surrounding the methotrexate experience.
Results showed that 79% of previous users and 58% of those currently taking the drug experienced one or more adverse effects. Fatigue was the most commonly reported event, at 44% for both the current and previous use subgroups.
Among those who discontinued the drug, gastrointestinal events, including nausea, abdominal pain, and loss of appetite were frequently reported. For example, nausea was cited as a significant event by 40% of previous users but just 26% of current users. In addition, 25% of previous users reported abdominal pain, compared with 9% of current users.
“Even though fatigue was most common in both the current and previous user subgroups, it looks like the gastrointestinal impact was what made a lot of patients say, ‘I can’t do this anymore,’” Nowell said.
Hair thinning and difficulty sleeping were some of the other common complaints associated with methotrexate.
However, despite these events, 65% of patients in the current use group felt that the drug was offering protection against disease outcomes. In addition, 43% of respondents agreed that life would be impossible without using the drug. The current data are baseline findings from initial responses to the survey. Nowell suggested that further analysis of the findings may yield other conclusions.
“These findings can help us understand how we can improve methotrexate adherence, how we can accelerate optimization, how we might find other therapies for patients who are unable to tolerate this drug,” Nowell said. – by Rob Volansky
Reference:
Nowell WB. Abstract #2256. Patient beliefs and perceptions of methotrexate for the treatment of rheumatoid arthritis and psoriatic arthritis. Presented at: American College of Rheumatology/Association of Rheumatology Professionals Annual Meeting; Nov. 9-13, 2019; Atlanta.