Adherence to Parenteral Methotrexate Compared to Oral Route in Patients with Rheumatoid Arthritis

Mariwan Ismail  Othman; Ziad Shafeeq  Al.Rawi

doi:10.56056/amj.2025.327

Authors

Mariwan Ismail Othman MBChB. KBMS Trainee, Department of Rheumatology, Rizgari Hospital Erbil, KRG
Ziad Shafeeq Al.Rawi MBChB, FRCP (London), Professor of Rheumatology, Department of Rheumatology, Rizgari Hospital, Erbil, KRG

DOI:

https://doi.org/10.56056/amj.2025.327

Keywords:

Adherence, Oral Methotrexate, Parenteral Methotrexate, Rheumatoid Arthritis

Abstract

Background and objectives: Rheumatoid arthritis is a chronic autoimmune inflammatory disease, which causes discomfort, swelling, stiffness, and eventual joint destruction. Methotrexate is a Disease Modifying Anti-Rheumatic Drug with a specific role in the treatment of Rheumatoid Arthritis. Adherence to methotrexate is essential to attain low disease activity or remission. The aim of this study was to know the prevalence rate of adherence to Methotrexate in parenteral way of administration and oral route among patients with Rheumatoid Arthritis.

Methods: This observational cross-sectional study included 100 patients diagnosed as rheumatoid arthritis according to 2010 ACR/EULAR using methotrexate either in oral or parenteral route presented to Rheumatology Consultancy Department at Rizgary Teaching Hospital/Erbil City, from July 2022 to July 2023. All patients answered an interview questionnaire regarding socio-demographic, clinical and treatment information survey included the Arabic version of the eight-item Morisky Medication Adherence Scale, and blood investigations had been done to assess the determinants of adherence to methotrexate treatment.

Results: A total of 100 patients with Rheumatoid Arthritis using methotrexate either in oral or parenteral route were enrolled in this study. No significant association was detected between the drug adherence with the following variables: age, body mass index, residency, and the factors related to pattern of diseases and treatment. While higher levels of adherence (2%) were detected among those with higher levels of education as significant association was detected (p = 0.021).

Conclusion: More than Two-Thirds of patients with Rheumatoid Arthritis who are receiving methotrexate via parenteral or oral route were poorly adherent to methotrexate.

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