Ab0421 methotrexate Compliance Among Patients With Chronic Inflammatory Disease or Connective Tissue Disease

Abstract

Background:Methotrexate (MTX) is widely used in rheumatology. About 30% of patients receiving MTX do not respond. One of the explanations could be poor adherence.Objectives:The purpose of this study was to assess adherence and to identify predictive factors influencing it.Methods:188 patients with MTX for at least 3 months (rheumatoid arthritis (RA), peripheral spondyloarthritis (PS), psoriatic arthritis (PA), lupus, Sjögren’s Syndrome (SS)) were enrolled between May 2017 and May 2018. Each patient completed a questionnaire including socio-demographic data, disease and MTX characteristics, 4-question Morisky, rheumatism activity scores including DAS 28, quality of life (EQ-5D), fibromyalgia (FiRST), anxiety and depression (HADS), catastrophism (PCS-CF), coping (WCC-R) and whether or not to participate in a therapeutic education program.Results:188 were recruited, of which 75% were women, with a mean age of 61.4 +/- 13.24 years: RA (77.12%), PS (7.98%), PA (10.11%), lupus (2.66%) and SS (2.13%). 68.6% were observant, versus 31.4% unobservant minor (28.2%) or major (3.2%) patients. In multivariate analysis, two models were performed and found a poor adherence in case of depression OR: 3.120 [1.051; 9.354], catastrophism OR: 3.974 [1.119; 14.108], anti-CCP antibodies OR: 4.019 [1.277; 12.653] in RA patients and depression OR: 2.715 [1.237; 5.963], absence of comorbidities OR: 2.309 [1.085; 4.915] with all rheumatism.Conclusion:Some modifiable factors such as depression and catastrophism were associated with the risk of non-adherence with MTX. It is important to consider depression and catastrophism when taking care of our patients to improve adherence and avoid therapeutic escalations.Disclosure of Interests:Elisabeth FILHOL: None declared, Charlotte Hua: None declared, Francoise Flaisler: None declared, Cédric Lukas: None declared, Bernard Combe Consultant for: Abbvie, Bristol-Myers Squibb, Gilead, Janssen, Eli Lilly, MSD, Novartis, Pfizer, Roche-Chugai, Sanofi, UCB, Jacques Morel: None declared, Cecile Gaujoux-Viala Consultant for: Speaking and/or consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Merck-Serono, Medac, Nordic Pharma, Novartis, Pfizer, Roche, Sandoz, Sanofi and UCB Pharma., Speakers bureau: Speaking and/or consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Merck-Serono, Medac, Nordic Pharma, Novartis, Pfizer, Roche, Sandoz, Sanofi and UCB Pharma.