The causes of non-adherence to methotrexate in patients with rheumatoid arthritis

Alrubaye, Yasir Sj.; Al-Juboori, Mohammed Bm.; Al-Humairi, Ameer Kadhim

doi:10.5958/0974-360x.2021.00134.7

Cited by 3 publications

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“…In our study, the multivariate analysis revealed that the concomitant use of steroids is an independent positive predictor of adherence, measured by the MARS-5 and CQR19. According to our knowledge, the influence of the concomitant use of steroids on MTX adherence was analyzed in only a few studies and the results are inconsistent [ 48 , 49 , 50 ]. For example, H. Bliddal et al did not find any influence of prednisolone therapy on MTX adherence [ 49 ], while the negative impact of concomitant steroid use was shown by Alrubaye et al [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…According to our knowledge, the influence of the concomitant use of steroids on MTX adherence was analyzed in only a few studies and the results are inconsistent [ 48 , 49 , 50 ]. For example, H. Bliddal et al did not find any influence of prednisolone therapy on MTX adherence [ 49 ], while the negative impact of concomitant steroid use was shown by Alrubaye et al [ 50 ]. On the other hand, Hoekstra M et al showed that the concomitant use of prednisolone remained significantly related to MTX therapy in a multivariate analysis, which is consistent with our results [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several research studies showed that the lack of comprehension related to MTX’s slow-acting effects can impact adherence [ 50 ]. Presumably, steroid administration with rapid and efficient action could have altered adherence.…”

Section: Discussionmentioning

confidence: 99%

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Assessment and Prediction of Adherence to Methotrexate Using Three Self-Report Questionnaires in Patients with Rheumatoid Arthritis

et al. 2023

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Introduction: Methotrexate (MTX) reduces rheumatoid arthritis activity and ameliorates the long-term functional status in these patients. To achieve this aim, patients need to take their medication regularly. Nevertheless, non-adherence to MTX still remains a considerable issue in the management of rheumatoid arthritis. Objective: This study aimed to estimate the adherence to methotrexate in patients with rheumatoid arthritis and to identify specific non-adherence risk factors. Methods: A cross-sectional study included 111 patients (mean age 56.2 ± 10.6 years, 78.4% female, and mean disease duration 6 years (3–13)). Three adherence self-assessment questionnaires were used: the Compliance-Questionnaire-Rheumatology (CQR19), the Medication Adherence Reports Scale (MARS-5), and the Visual Analogue Scale (VAS). We also collected demographic data, disease and treatment characteristics, and anxiety/depression estimation results (Hospital Anxiety and Depression Scale, HADS). Results: Adherence was identified in 48.6% of patients (COR19), 70.3% of patients (MARS-5), and 82.9% of patients (VAS questionnaire). All three questionnaires displayed a significant positive mutual correlation: CQR19 with MARS-5 and VAS (r = 0.364, r = 0.329, respectively, p < 0.001 for both) and between the VAS and MARS-5 scores (r = 0.496, p < 0.001). A significant positive prediction was shown for urban residence (0.347 (0.134–0.901), p = 0.030) using the MARS-5, female sex (0.264 (0.095–0.730), p = 0.010) according to the CQR19, and for a dose of methotrexate (0.881 (0.783–0.992), p = 0.036) using the VAS, while negative predictions were shown for comorbidity number (3.062 (1.057–8.874), p = 0.039) and depression (1.142 (1.010–1.293), p = 0.035) using the MARS-5 and for older age (1.041 (1.003–1.081), p = 0.034) according to the CQR19. The use of steroids was a significant positive predictor in all three questionnaires and remained an independent predictor for methotrexate adherence in the multivariate logistic regression. Conclusions: We showed non-adherence to methotrexate in a significant number of patients using all three questionnaires. Concomitant steroid therapy emerged as an independent positive predictor for adherence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Assessment and Prediction of Adherence to Methotrexate Using Three Self-Report Questionnaires in Patients with Rheumatoid Arthritis

et al. 2023

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Effect of Omega 7 on Some Parameters Related to WBCs and RBCs in Methotrexate-induce Blood Toxicity in Mice

Hassani

Hassan

2023

RJPT

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Background: Although methotrexate (MTX) is a frequently used chemotherapy drug, its effectiveness is sometimes hampered by the drug's toxic consequences. Omega 7 is a monounsaturated fatty acid, with different anti-inflammatory, anti-diabetic anti-obesity applications, and its possible protective effects against MTX-induced blood toxicity were investigated in this study. Objective: Evaluation of possible protective effects of omega7 against MTX-induced blood toxicity. Methods: 30 mice were divided into five groups, the First group take liquid paraffin orallyfor 7 days for served as negative control and the second group take methotrexate (20mg/kg) intraperitoneallyto serve as a positive control,the third group takes omega 7 (100mg/kg)orally for 7 days, forth groupreceived (50mg/kg ) omega 7orally for 7 days as well as give It methotrexate (20mg/kg) on day 8, the fifth groupreceived (100mg/kg ) omega 7orally for 7 days as well as give It methotrexate (20mg/kg) on day 8. After that, the animals were killed and took blood samples for measuring blood parameters, such as PCV, Hb, MCV, MCH, platelet, WBC count and Differential WBC. Results: the results showed the presence of a decrease in both the RBC from which MCV and MCH count showed a significant decrease at a dose of 20mg/kg concentration of methotrexate, omega7 at a dose of 50 and 100 mg/kg work to increase the variables above, Concerning the WBC was significantlydecreased in the totals and increased in monocytes count for the study when giving methotrexate while reversed when giving omega7 with this drug. Conclusion: omega7 has a significant protective role in Methotrexate-induce Blood Toxicity in Mice.

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An Overview on Causes of Nonadherence in the Treatment of Rheumatoid Arthritis: Its Effect on Mortality and Ways to Improve Adherence

Chowdhury¹,

Dutta²,

Noel³

et al. 2022

Cureus

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Rheumatoid arthritis is one of the most prevalent musculoskeletal disorders that, when insufficiently treated, results in detrimental sequelae including joint damage and reduced quality of life. Poor patient adherence to medication is a significant blockade to effective management. The purpose of this review is to highlight and discuss the factors responsible for defiance of antirheumatic medication and ways to overcome these barriers. Education level, health literacy, cohabitation status, multi-morbidities, complicated drug regimen, intermittent co-payments, prescribed regimen adverse effects, and cognitive impairment are a few among many common barrier factors leading to poorer outcomes in rheumatoid arthritis. While there is an abundance of inhibitory factors leading to worsening disease progression, they each can be easily dealt with an effective approach at the beginning or during the treatment course to ensure a better outcome.

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The causes of non-adherence to methotrexate in patients with rheumatoid arthritis

Cited by 3 publications

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Assessment and Prediction of Adherence to Methotrexate Using Three Self-Report Questionnaires in Patients with Rheumatoid Arthritis

Assessment and Prediction of Adherence to Methotrexate Using Three Self-Report Questionnaires in Patients with Rheumatoid Arthritis

Effect of Omega 7 on Some Parameters Related to WBCs and RBCs in Methotrexate-induce Blood Toxicity in Mice

An Overview on Causes of Nonadherence in the Treatment of Rheumatoid Arthritis: Its Effect on Mortality and Ways to Improve Adherence

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