Evidence map›Paper›PMID 38772677›Full record

ArticleRMD open2024

Urinary methotrexate dosage in rheumatoid arthritis, in patients treated for at least 6 months: a potential marker of adherence.

Noémie Théate, Marion Geoffroy, Lukshe Kanagaratnam, Claire Gozalo, Isabelle Charlot, Lois Bolko, Ambre Hittinger-Roux, Zoubir Djerada, Jean-Hugues Salmon

Registry-linked trialAbstract read
In one paragraph

Article in RMD open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03852888 (Kinetics of Elimination of Methotrexate and Its Major Metabolite 7-OH-methotrexate for Observant Patients), 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
–field-weighted citation impact
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.

NCT03852888 nacompletednot on this map

Kinetics of Elimination of Methotrexate and Its Major Metabolite 7-OH-methotrexate for Observant Patients

TypeinterventionalSponsorCHU de ReimsRan2018 to 2021Enrolled62ConditionsRheumatoid ArthritisArmsUrine samples taken to measure methotrexate and its major metabolite 7-OH-methotrexate level
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  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

9 authors.

Noémie ThéateRhumatologie, Université de Reims Champagne-Ardenne, Reims, France ntheate@chu-reims.fr.ORCID 0009-0003-6674-3536
Marion GeoffroyRhumatologie, Centre Hospitalier Universitaire de Reims, Reims, France.
Lukshe KanagaratnamUR 3797 VieFra, Université de Reims Champagne-Ardenne, Reims, France.
Claire GozaloUR 3801 PPF, Université de Reims Champagne-Ardenne, Reims, France.
Isabelle CharlotRhumatologie, Centre Hospitalier Universitaire de Reims, Reims, France.
Lois BolkoRhumatologie, Centre Hospitalier Universitaire de Reims, Reims, France.
Ambre Hittinger-RouxRhumatologie, Centre Hospitalier Universitaire de Reims, Reims, France.
Zoubir DjeradaUR 3801 PPF, Université de Reims Champagne-Ardenne, Reims, France.
Jean-Hugues SalmonRhumatologie, Université de Reims Champagne-Ardenne, Reims, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesNon-adherence to rheumatoid arthritis (RA) treatments must be identified. A methotrexate (MTX) urinary dosage (METU) was recently developed. The aim of our study was to assess adherence to MTX in RA using METU in real-life conditions and to compare it with indirect adherence measurement technics.

methodsWe performed a cross-sectional study at Reims University Hospital. We included over 18-year-old patients with RA treated by MTX for more than 6 months. Patients were invited to complete demographic, clinical and psychological questionnaires and adherence measurement technics (Compliance Questionnaire of Rheumatology (CQR) and Medication Possession Ratio (MPR)). A urinary sample was collected to measure MTX and information about tolerance was evaluated through Methotrexate Intolerance Severity Score.

results84 patients were included, 26 using oral MTX, 58 subcutaneous (SC) MTX. Among them, 73% were female, mean age was 61.5 years, MTX mean dose was 15 mg/week and 61.9% were treated by biological DMARDs (Disease Modifying Antirheumatic Drugs). 77 patients (91.7%) were adherent to treatment according to METU, whereas MPR and CQR reported less adherence (69.5% and 61.9%, respectively). MPR and METU were not significantly different in SC MTX users (p=0.059). Non-adherent patients had a higher number of tender joints and C reactive protein value (p<0.05).

conclusionThis is the first largest study evaluating MTX adherence in patients with RA using a urinary dosage. We identified that indirect adherence measurements did not reflect real-life adherence. It would be appreciable to realise METU, in a new study, in patients with RA with unexplained response to treatment, to consider it before escalating therapeutic strategy.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidMedication AdherenceMethotrexateAdultAgedBiomarkersCross-Sectional StudiesFemaleHumansMaleMiddle AgedSurveys and QuestionnairesAntirheumatic AgentsBiomarkersMethotrexatemethotrexatepharmacokineticsrheumatoid arthritissensitivity and specificitytherapeutics

Identifiers

PMID38772677
PMCPMC11328664

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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.