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Successful treatment of methotrexate intolerance in juvenile idiopathic arthritis using eye movement desensitization

Lea Höfel1,2, Bruno Eppler1,2, Magdalena Storf1,2

  • 1German Center for Pediatric and Adolescent Rheumatology (DZKJR), Gehfeldstrasse 24, 82467, Garmisch-Partenkirchen, Germany.

Pediatric Rheumatology Online Journal
|February 14, 2018
PubMed
Abstract

Insights

Eye Movement Desensitization and Reprocessing (EMDR) effectively treated methotrexate (MTX) intolerance in juvenile idiopathic arthritis (JIA) patients. This psychological intervention improved symptoms and quality of life, allowing continued MTX treatment.

Area of Science:

  • Pediatric Rheumatology
  • Psychological Therapies
  • Gastrointestinal Disorders

Background:

  • Methotrexate (MTX) is a common treatment for juvenile idiopathic arthritis (JIA).
  • MTX intolerance, marked by gastrointestinal issues, often leads to treatment discontinuation.
  • Eye Movement Desensitization and Reprocessing (EMDR) is a psychological technique for reprocessing distressing memories.

Purpose of the Study:

  • To evaluate the effectiveness of EMDR in managing MTX intolerance in JIA patients.
  • To assess the impact of EMDR on the quality of life for children with JIA undergoing MTX treatment.

Main Methods:

  • An open prospective study involving JIA patients with MTX intolerance.
  • Assessment of MTX intolerance using the Methotrexate Intolerance Severity Score (MISS) before and after EMDR.
  • Evaluation of health-related quality of life using the PedsQL questionnaire.
  • Treatment administered via an 8-session EMDR protocol over two weeks.

Main Results:

  • Significant reduction in MTX intolerance symptoms directly after EMDR treatment (median MISS decreased from 16.5 to 1).
  • Sustained improvement in MTX intolerance at four months post-treatment (median MISS 6.5, p=0.001).
  • Significant improvement in health-related quality of life (PedsQL) at four months (77.6% to 85.3%, p=0.008).

Conclusions:

  • EMDR therapy provides an effective treatment for MTX intolerance in pediatric patients with JIA.
  • The positive effects of EMDR on MTX intolerance and quality of life are sustained for at least four months.
  • EMDR offers a potential strategy to improve patient quality of life and facilitate continued methotrexate therapy.
Keywords:
Adverse effectsEMDRIntoleranceJuvenile idiopathic arthritisMethotrexate

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