Tolerability and Adherence Problems in Patients on a Stable Dose of Methotrexate: Results of a Multicenter Survey

    December 2015 in “ Musculoskeletal care ”
    Sandra Robinson, S Gibson, Emmanuel George, Una Martin, Peta Heslop, H Wrightson, P Prowse, Matthew Kalinowski, David A. Marshall, Marty Reed, Ade Adebajo, David Walker
    TLDR Many patients on methotrexate experience significant side effects but still continue the medication.
    The study surveyed patients on a stable dose of methotrexate for inflammatory arthritis to assess side effects and adherence. Conducted across seven centers, the survey found that 57%-86% of patients experienced side effects, with fatigue (53%), nausea (38%), mouth ulcers (23%), and hair loss (23%) being the most common. Efficacy was rated at 6.5 cm on a 10-cm visual analogue scale (VAS), while toxicity scores varied, with fatigue at 5.9 cm and hair loss at 3.9 cm. Adherence issues were notable, with 13.5% of patients forgetting to take the drug for an average of two weeks, and 25% for 2.5 weeks in the previous year. The study concluded that despite significant side effects, patients continued methotrexate therapy, highlighting the need for further research on adherence.
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