Methotrexate Intolerance in Elderly Patients with Rheumatoid Arthritis at HMIMV

Hassaine M, Tchimou A, Hinda H, Tadlaoui Y and Bousslimane Y

Department of Pharmacy, Mohammed V Military Training Hospital Rabat, Morrocco  Clinical Pharmacy Laboratory, Faculty of Medicine and Pharmacy Rabat, Morrocco  Toxicology Laboratory, Faculty of Medicine and Pharmacy, Rabat, Morrocco

^*Correspondance to: Hassaine Mohamed 

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Abstract:

Objective: The aim of this study was to identify the frequency and risk factors of methotrexate (MTX) intolerance in elderly patients using the Methotrexate Intolerance Severity Score (MISS) questionnaire among those with rheumatoid arthritis (RA). Methods: This was a cross-sectional study involving elderly patients aged 60 years and above with RA treated with MTX. After dispensing MTX at the retrocession unit for drugs with specific status, a personal interview was conducted, collecting sociodemographic, clinical, and paraclinical data. MTX tolerance was assessed using the MISS questionnaire, which includes five items: abdominal pain, nausea, vomiting, fatigue, and behavioral disorders. Each item was scored from 0 to 3 based on severity (no complaint, mild, moderate, severe). MTX intolerance was defined as a total score exceeding 6. Results: A total of 100 patients aged 60 and above were included, of whom 65.38% were women, 92% were married, and 20.6% were illiterate. All patients received folic acid supplementation. Twelve percent were on biological treatments. MTX intolerance was observed in 34 patients using the MISS questionnaire. Gastrointestinal symptoms were reported in decreasing frequency as follows: abdominal pain (72.1%), nausea (51.1%), vomiting (29.5%), and behavioral disorders (4.1%).  Conclusion: The prevalence of MTX intolerance among RA patients was moderate. Screening for MTX intolerance should be integrated into patient management alongside therapeutic education to optimize disease management outcomes.

Keywords:

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Cite the Article:

Hassaine M, Tchimou A, Hinda H, Tadlaoui Y, Bousslimane Y. Methotrexate Intolerance in Elderly Patients with Rheumatoid Arthritis at HMIMV. World J Surg Surgical Res. 2025; 8: 1586..