Complications occurrence during methotrexate therapy in rheumatoid arthritis

Abstract

Introduction: Methotrexate (MTX) is now considered the first-line DMARD agent for most patients with Rheumatoid Arthritis (RA). It has a relatively rapid onset of action at therapeutic doses (6- 8 weeks), good efficacy and ease of administration. But it can also determine the appearance of sideeffects, especially pulmonary and haematological. The objectives of the study are to reveal the most frequent complications that occur during the treatment. Materials and methods: The research is based on the information from medical records of patients that have been hospitalized at Clinical Republican Hospital during 2015. A cohort of 50 RA patients (47 women, 3 men), aged between 32-74 years (with a mean age of 53 years), was studied for the occurrence of side-effects. 37 patients (74%) were on MTX treatment. Discussion results: Adverse broncho-pulmonary side-effects were observed in 7 patients (18,9%), with a mean disease duration of 5 years. All of the cases were confirmed by the X-ray. Anaemia was present at 14 patients (37%), only 4 of them (28,5%) presented mild anaemia and 10 patients (71%) – moderate anaemia. The mean disease duration was of 6 years. Four patients (10,8%) abandoned the treatment, three of which (8,1%) developed drug intolerance, and in one case for an unknown reason. Conclusion: Pulmonary, haematological and other side-effects are not a rare event during MTX therapy in RA. Improved education of patients and physicians should certainly lead to a decreased number of complications by stopping the treatment as soon as the early symptoms of damage occur.