Gastrointestinal adverse effects of methotrexate in patients with juvenile idiopathic arthritis – are they properly assessed?


Authors: P. Mrážik;  V. Vargová
Authors‘ workplace: Klinika detí a dorastu LF UPJŠ a DFN, Košice, prednostka doc. MUDr. I. Schusterová, PhD.
Published in: Čes-slov Pediat 2015; 70 (4): 215-219.
Category: Original Papers

Overview

Aim:
The term juvenile idiopathic arthritis encompasses all forms of arthritis that appeared before 16 years of age, remain at least six weeks and their etiology is unknown. For patients with juvenile idiopathic arthritis methotrexate therapy is generally considered to be an effective, safe and well tolerated.

Methods:
We assessed the prevalence of methotrexate gastrointestinal adverse effects in a group of 88 patients with juvenile idiopathic arthritis at rheumatology outpatient clinic of Children's Faculty Hospital in Košice, Slovakia. Gastrointestinal adverse effects were evaluated according to their intensity and duration (mild, moderate, severe) and on the basis of a causal relationship (possible, probable, definite).

Results:
The methotrexate gastrointestinal adverse effects were found in 20 (22.7 %) of 88 patients, in the total number 21. The causal relationship to methotrexate treatment was „definite“ in 90 %. The most common symptoms were mild.

Conclusion:
Gastrointestinal adverse effects due to methotrexate treatment may lead to non-adherence or refusal of treatment by relevant group of pediatric patients or their parents. The use of a standardized questionnaire could help to clarify the prevalence of patients with methotrexate intolerance in routine outpatient practice and the proper interpretation of difficulties. Thus allows early intervention prior to the loss of trust between patient and physician.

Key words:
juvenile idiopathic arthritis, methotrexate, adverse effects, intolerance


Sources

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Labels
Neonatology Paediatrics General practitioner for children and adolescents
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