Evidence map›Paper›PMID 33709166›Full record

ArticleZeitschrift fur Rheumatologie2021

[Patient safety in the treatment of rheumatic diseases : Laboratory monitoring in methotrexate treatment].

Elizabeth Sierocinski, Aniela Angelow, Armin Mainz, Jochen Walker, Jean-François Chenot

Registry-linked trialOpen access · greenAbstract read
In one paragraph

Article in Zeitschrift fur Rheumatologie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07512401 (Safety of Reduced Methotrexate Lab Monitoring), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 52% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07512401 completednot on this map

Safety of Reduced Methotrexate Lab Monitoring: a Population-based, Target Trial Emulation Study

TypeobservationalSponsorMayo ClinicRan2012 to 2025Enrolled2,414ConditionsRheumatic DiseasesArmsStandard methotrexate lab monitoring, Reduced methotrexate lab monitoring
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Elizabeth SierocinskiAbteilung Allgemeinmedizin, Institut für Community Medicine, Universitätsmedizin Greifswald, Fleischmannstr. 6, 17485, Greifswald, Deutschland. elizabeth.sierocinski@med.uni-greifswald.de.ORCID http://orcid.org/0000-0003-3679-671X
Aniela AngelowAbteilung Allgemeinmedizin, Institut für Community Medicine, Universitätsmedizin Greifswald, Fleischmannstr. 6, 17485, Greifswald, Deutschland.ORCID http://orcid.org/0000-0003-1027-231X
Armin MainzHausarztpraxis Korbach, Korbach, Deutschland.
Jochen WalkerInGef - Institut für angewandte Gesundheitsforschung Berlin (früher Health Risk Institute), Berlin, Deutschland.ORCID http://orcid.org/0000-0002-7838-7829
Jean-François ChenotAbteilung Allgemeinmedizin, Institut für Community Medicine, Universitätsmedizin Greifswald, Fleischmannstr. 6, 17485, Greifswald, Deutschland.ORCID http://orcid.org/0000-0001-8877-2950
Universitätsmedizin Greifswald · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMethotrexate (MTX) is the most commonly prescribed disease-modifying drug in the treatment of rheumatic diseases. Regular laboratory testing is recommended to recognize side effects, such as hepatotoxicity and myelotoxicity as well as decreases in renal function that may cause toxic MTX accumulation. Additionally, folic acid is recommended as prophylaxis against specific side effects. In this study we investigated whether laboratory monitoring and prescription of folic acid took place according to published recommendations. MATERIAL AND

methodsClaims data from the statutory health insurance from 1 January 2009 to 31 December 2013 were retrospectively analyzed. A total of 40,087 adults with a rheumatic diagnosis (ICD10 codes M05-M18), no malignant disease and no previous MTX prescription within 12 months were extracted from the InGef (Institute for Applied Health Research in Berlin, formerly Health Risk Institute) research database. The frequency of recommended laboratory testing, appointments with rheumatologists and the prescription of folic acid prophylaxis were investigated.

resultsOf the patients 12,451 began treatment with MTX in the observation period. Between 42% and 46% of recommended blood counts, liver values and kidney function tests and 14% of urinalyses were performed according to recommendations. Of the patients 84% were seen regularly by a rheumatologist and 74% received a prescription for prophylactic folic acid. Serious conditions potentially resulting from MTX treatment were observed in 0.7-3.5 cases/1000 person years. DISCUSSION: Laboratory monitoring in the context of MTX treatment is carried out less frequently than recommended in the literature. Potential MTX-associated serious complications are rare from a practice perspective. On the one hand solutions are needed for a better coordination of laboratory monitoring. On the other hand more empirical evidence is needed regarding the benefits of laboratory monitoring and the appropriate intervals thereof.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidRheumatic DiseasesAdultHumansLaboratoriesMethotrexatePatient SafetyRetrospective StudiesAntirheumatic AgentsMethotrexateAdverse eventsDrug monitoringGuidelinesMethotrexatePharmacovigilance

Identifiers

PMID33709166
PMCPMC8189943
OpenAlexW3134408276

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.