• Minerva medica · Apr 2021

    Multicenter Study Observational Study

    Long-term methotrexate use in Rheumatoid Arthritis patients: real-world data from the MARTE study.

    • Teodora Serban, Roberto Allara, Valeria Azzolini, Claudio Bellintani, Laura Belloli, Nebiat Belai Beyene, Romano Bucci, Roberto Caporali, Antonella Cappelli, Vincenzo Corbelli, Fabio DE Gennaro, Enrico Fusaro, Andrea Giusti, Marcello Govoni, Luca Magnani, Ciro Manzo, Ciro Romano, Maurizio Rossini, Daniele Santilli, Gianantonio Saviola, Luigi Sinigaglia, Gerolamo Bianchi, and MARTE study group.
    • S.C. Rheumatology, Department of Locomotor System, ASL3 Genovese, Genoa, Italy - teodoramazdrag@yahoo.com.
    • Minerva Med. 2021 Apr 1; 112 (2): 246-254.

    BackgroundThe MARTE study investigated the demographic, clinical, and therapeutic characteristics of rheumatoid arthritis (RA) patients ongoing methotrexate (MTX) treatment for longer than 8 years.MethodsThis cross-sectional, observational study considered 587 RA patients from 67 Rheumatology Units across Italy. Data collected included demographic, clinical, and therapeutic characteristics, focusing on MTX prescription patterns (route of administration, dosing regimens, treatment duration, and discontinuation).ResultsAs initial therapy, 90.6% of patients received one conventional synthetic Disease Modifying Anti Rheumatic Drug (csDMARD), with treatment started within the first 3 months from diagnosis in half of the patients. MTX was the first csDMARD in 46.2% of patients. The prevalent route of administration at diagnosis was the intramuscular (60.5%), while at study entry (baseline) 57.6% were receiving subcutaneous MTX. Patients who required a higher MTX dose at study entry were those who received a significantly lower starting MTX dose (P<0.001). Significantly higher MTX doses were currently required in men (P<0.001), current smokers (P=0.013), and overweight patients (P=0.028), whereas patients on oral therapy received significantly lower doses of MTX (P<0.001).ConclusionsThe MARTE study confirms once again the potential of the proper use of MTX in the treatment of RA. Data from our study suggest that a higher dose of MTX should be used since the first stages in overweight patients, men, and smokers.

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