Oude Lansink M A M, Pongers S A S, Bekker C L, Eikelboom D, Ten Cate D F, van den Bemt B J F, Huiskes V J B
Department of Research, Sint Maartenskliniek, Hengstdal 3, 6574 NA, Ubbergen, Nijmegen, The Netherlands.
Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands.
Int J Clin Pharm. 2025 Jun;47(3):884-890. doi: 10.1007/s11096-025-01904-4. Epub 2025 Apr 3.
Methotrexate (MTX) is the cornerstone of rheumatoid arthritis (RA) treatment. However, patients using MTX often experience drug-related problems (DRPs), negatively affecting adherence and persistence.
To identify the number and type of DRPs experienced by RA patients during the first 3 months of MTX treatment.
A longitudinal observational study was conducted in the Sint Maartenskliniek, The Netherlands, between March and August 2023. Adult RA patients were interviewed at 2, 6 and 12 weeks after MTX initiation using the United Kingdom's New Medicines Service interview guide. DRPs were categorized using a classification system for patient-reported DRPs, and analyzed descriptively.
All fifty participants (median age 62 years (IQR 51-68), 66% female) reported a DRP, with a median of 6 (IQR 3-8) DRPs per patient and a total of 301 DRPs. The top 5 most frequently reported DRPs were concerns about (long-term) side-effects, nausea, fatigue, remembering intake and information needs regarding dose instructions. Of the DRPs reported at weeks 2 and 6, 33% were unresolved at week 12.
Patients with RA experience numerous DRPs in the first 3 months of MTX use. Resolving DRPs soon after occurrence may reduce the burden of drug treatment and improve adherence and/or persistence.
甲氨蝶呤（MTX）是类风湿关节炎（RA）治疗的基石。然而，使用MTX的患者经常会出现与药物相关的问题（DRPs），对依从性和持续性产生负面影响。
确定RA患者在MTX治疗的前3个月中经历的DRPs的数量和类型。
2023年3月至8月在荷兰的圣马丁诊所进行了一项纵向观察性研究。使用英国新药服务访谈指南，在MTX开始使用后的第2、6和12周对成年RA患者进行访谈。DRPs使用患者报告的DRPs分类系统进行分类，并进行描述性分析。
所有50名参与者（中位年龄62岁（四分位间距51 - 68），66%为女性）均报告了DRP，每位患者的DRP中位数为6（四分位间距3 - 8），总共报告了301个DRP。最常报告的前5个DRP是对（长期）副作用、恶心、疲劳、忘记服药以及剂量说明的信息需求的担忧。在第2周和第6周报告的DRP中，33%在第12周仍未解决。
RA患者在使用MTX的前3个月中经历了许多DRP。DRP出现后尽快解决可能会减轻药物治疗负担，并提高依从性和/或持续性。
