Falvey Sonja, Shipman Lauren, Ilowite Norman, Beukelman Timothy
University of Mississippi School of Pharmacy, Oxford, USA.
Division of Pediatric Rheumatology, University of Alabama Birmingham, Birmingham, USA.
Pediatr Rheumatol Online J. 2017 Jun 19;15(1):52. doi: 10.1186/s12969-017-0180-2.
Methotrexate is the most commonly used disease modifying antirheumatic drug in the treatment of juvenile idiopathic arthritis and can be effective in controlling disease in many patients.
A significant proportion of patients experience nausea and vomiting induced by methotrexate therapy, which can lead to decreased quality of life and discontinuation of treatment with methotrexate. Many strategies have been employed in attempts to reduce methotrexate-induced nausea, including folate supplementation, switching from oral to subcutaneous methotrexate, anti-emetic therapy, behavioral therapy, and others. Anticipatory nausea can be difficult to treat, making primary prevention of nausea with anti-emetics an attractive approach.
Understanding the prevalence and impact of methotrexate-induced nausea, as well as potentially effective interventions, may help maximize the therapeutic benefits of methotrexate.
甲氨蝶呤是治疗青少年特发性关节炎最常用的改善病情抗风湿药物，对许多患者的病情控制有效。
相当一部分患者在接受甲氨蝶呤治疗时会出现恶心和呕吐，这会导致生活质量下降并中断甲氨蝶呤治疗。为减少甲氨蝶呤引起的恶心，人们采用了多种策略，包括补充叶酸、从口服甲氨蝶呤改为皮下注射、抗呕吐治疗、行为疗法等。预期性恶心可能难以治疗，因此用抗呕吐药进行恶心的一级预防是一种有吸引力的方法。
了解甲氨蝶呤引起恶心的发生率和影响，以及潜在的有效干预措施，可能有助于使甲氨蝶呤的治疗益处最大化。
