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Prevalence of methotrexate intolerance among patients with rheumatoid arthritis using the Arabic version of the

Jawza Albaqami1,2, Rawan Alshalhoub1, Haya Almalag1

  • 1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.

International Journal of Rheumatic Diseases
|June 28, 2019
PubMed
Abstract

Insights

The Arabic Methotrexate Intolerance Severity Score (MISS) is a valid and reliable tool for identifying methotrexate intolerance in rheumatoid arthritis patients. This condition is common, affecting nearly 40% of patients in the study.

Area of Science:

  • Rheumatology
  • Clinical Pharmacology
  • Health Sciences

Background:

  • Methotrexate (MTX) is a primary treatment for rheumatoid arthritis (RA).
  • Adverse events associated with MTX can limit its efficacy.
  • The Methotrexate Intolerance Severity Score (MISS) aids in identifying MTX-related symptoms.

Purpose of the Study:

  • To translate and validate the MISS into the Arabic language.
  • To assess the prevalence of MTX intolerance in Arabic-speaking RA patients.

Main Methods:

  • The MISS underwent forward and backward translation by bilingual translators and review by rheumatologists.
  • 185 RA patients using MTX for at least 3 months were recruited from two Saudi Arabian tertiary care centers.
  • Internal consistency and stability were evaluated using Cronbach's alpha and test-retest methods, with a positive test defined as a score of ≥6.

Main Results:

  • 185 RA patients were included, with 85.4% being female. The mean age was 49.7 years.
  • 39.5% of patients (73/185) reported positive MISS results, indicating MTX intolerance.
  • The Arabic MISS demonstrated good internal consistency (Cronbach's alpha = 0.792) and reliability for factor analysis (KMO = 0.745).

Conclusions:

  • The Arabic version of the MISS is a valid and reliable instrument for detecting MTX intolerance in RA patients.
  • MTX intolerance is a significant issue among RA patients in the studied population.
  • Further research with larger cohorts is recommended to corroborate these findings.
Keywords:
cross-cultural validation studiesmethotrexatemethotrexate intolerance severity scorerheumatoid arthritis

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