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Daily practices regarding safety monitoring of low-dose methotrexate and comparison to guidelines: A population-based

Canelle Mazaud1, Laurence Fardet2

  • 1Service de dermatologie, hôpital Henri-Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.

Therapie
|May 2, 2020
PubMed
Abstract

Insights

Safety monitoring for low-dose methotrexate is infrequent, with only 50-70% of patients receiving recommended tests. Increased monitoring frequency correlates with earlier discontinuation of methotrexate treatment.

Area of Science:

  • Pharmacovigilance
  • Real-world evidence in drug safety
  • Methotrexate therapy monitoring

Background:

  • Low-dose methotrexate is widely prescribed.
  • Optimal safety monitoring practices are crucial for patient well-being.
  • Current monitoring adherence requires investigation.

Purpose of the Study:

  • To characterize safety monitoring practices for low-dose methotrexate (≤30mg/week).
  • To identify factors influencing these monitoring practices.
  • To evaluate the relationship between monitoring frequency and early methotrexate discontinuation.

Main Methods:

  • Population-based cohort study using French claims data (2009-2015).
  • Analysis of pre-treatment and post-treatment monitoring for incident methotrexate users.
  • Logistic regression and Cox proportional-hazards models were employed.

Main Results:

  • Only 2472 incident methotrexate users (0.40%) were identified.
  • Pre-treatment testing rates for albumin, serologies, and chest X-ray ranged from 49.7% to 67.0%.
  • Frequent monitoring during treatment was associated with early methotrexate discontinuation.

Conclusions:

  • Safety monitoring for low-dose methotrexate is less frequent than recommended.
  • Higher monitoring frequency is linked to earlier treatment cessation.
Keywords:
MethotrexateMonitoringPopulation-basedSafety

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