AI Article Synopsis

  • Methotrexate (MTX) is an effective treatment for rheumatoid arthritis (RA), but its parenteral form is underused, prompting exploration of patient perspectives on barriers and enablers.
  • A scoping review of studies revealed that patients are generally satisfied with MTX injections, but factors like the need for dexterity in administration can be challenging, while low pain associated with injections is a positive aspect.
  • The research highlights a preference for easy-to-use parenteral MTX devices, yet there are significant gaps in qualitative research on this topic.

Article Abstract

Objective: Methotrexate (MTX) is effective in controlling disease activity in rheumatoid arthritis (RA). Parenteral MTX may have benefits over oral MTX, but it is rarely used in practice. To better understand this low usage rate, it is necessary to explore the barriers and enablers of therapy from the perspective of RA patients. The objectives of this scoping review were to describe RA patients' perspectives on the barriers and enablers in the use of parenteral MTX and to identify the research gaps in this field.

Methods: The search was performed in Medline, Embase, Scopus, and Cochrane Library from inception to May 2021. Data synthesis was conducted using the Theoretical Framework of Acceptability. This scoping review included any type of study that explored the use of parenteral MTX by adult RA patients from the patients' perspective, written in English.

Results: Fifteen studies were included; findings related to the constructs "affective attitude," "burden," "intervention coherence," and "self-efficacy" were explored the most, while some were rarely ("opportunity cost" and "perceived effectiveness") or not ("ethicality") reported. RA patients were generally satisfied with MTX injections ("affective attitude"). From the burden construct, the requirement for dexterity for administering MTX by injection was considered a barrier, whereas the lack of significant pain from MTX injection was considered an enabler.

Conclusion: The findings suggested that patients generally preferred parenteral MTX formulations with attributes that facilitate self-administration. However, much of the identified research focused on prefilled pen devices, and significant gaps were identified, such as a lack of qualitative research.

Download full-text PDF

Source
http://dx.doi.org/10.1002/acr.25141DOI Listing

Publication Analysis

Top Keywords

parenteral mtx
16
barriers enablers
12
scoping review
12
mtx
9
enablers parenteral
8
rheumatoid arthritis
8
"affective attitude"
8
patients generally
8
mtx injection
8
injection considered
8

Similar Publications

Article Synopsis
  • The study aimed to create a complex PK-PD model to understand how methotrexate polyglutamates in red blood cells affect disease activity in rheumatoid arthritis.
  • Researchers used data from 117 RA patients to fit the model and performed simulations comparing two dosing regimens of methotrexate.
  • Results showed that a loading dose regimen significantly increased drug concentration and improved patient responses compared to standard dosing after 4 weeks.
View Article and Find Full Text PDF
Article Synopsis
  • Methotrexate (MTX) toxicity is influenced by factors like dosing frequency, dosage, and administration route, with renal impairment worsening the toxicity.
  • Low-dose MTX overdoses are usually safe, but repeated doses and higher doses increase toxicity risk, necessitating different treatments with folinic acid depending on the scenario.
  • Glucarpidase can quickly reduce MTX levels in severe cases, especially intrathecal poisoning, but is costly and limited in availability; other supportive therapies like hydration and haemodialysis may also be helpful.
View Article and Find Full Text PDF

Co-Delivery of Aceclofenac and Methotrexate Nanoparticles Presents an Effective Treatment for Rheumatoid Arthritis.

Int J Nanomedicine

March 2024

Biomedical Parasitology and Translational-Immunology Lab, Division of Cell Biology and Immunology, CSIR-Institute of Microbial Technology (IMTECH), Chandigarh, 160036, India.

Background: Rheumatoid arthritis (RA) is a common acute inflammatory autoimmune connective tissue arthropathy. The genetic studies, tissue analyses, experimental animal models, and clinical investigations have confirmed that stromal tissue damage and pathology driven by RA mounts the chronic inflammation and dysregulated immune events.

Methods: We developed methotrexate (MTX)-loaded lipid-polymer hybrid nanoparticles (MTX-LPHNPs) and aceclofenac (ACE)-loaded nanostructured lipid carriers (ACE-NLCs) for the efficient co-delivery of MTX and ACE via intravenous and transdermal routes, respectively.

View Article and Find Full Text PDF

Thermally-responsive and reduced glutathione-sensitive folate-targeted nanocarrier based on alginate and pluronic F127 for on-demand release of methotrexate.

Int J Biol Macromol

April 2024

Graduate University of Science and Technology, Vietnam Academy of Science and Technology, HCMC, Viet Nam; Institute of Applied Materials Science, Vietnam Academy of Science and Technology, HCMC, Viet Nam. Electronic address:

A specific rheumatoid arthritis (RA)-microenvironment-triggered nanocarrier for RA treatment of a first-line antirheumatic drug (Methotrexate, MTX) has been proposed. Reduced glutathione (GSH) responsivity, cystamine, was first introduced on the alginate backbone, which was then used as the bridge to connect pluronic F127 (temperature-responsive factor) and folic acid (targeting factor for active immune cells), resulting in dual-responsive triggered targeting carrier, PCAC-FA. In vitro study demonstrated that PCAC-FA was preferentially taken up by activated macrophage cells rather than normal ones, suggesting the targeting of PCAC-FA to inflamed tissue.

View Article and Find Full Text PDF

A novel selective and reliable ratiometric fluorescence probe has been successfully synthesized for precise, sensitive, and simple quantitation of methotrexate (MTX). Hydrothermal method was employed to fabricate nitrogen-doped carbon dots using Annona squamosa seeds (AS-CDs) as a starting material, and their characteristics were confirmed using transmission electron microscopy (TEM), UV-Vis spectroscopy, fluorescence spectroscopy, X-ray diffractometry (XRD), and Fourier Transform Infrared Spectroscopy (FTIR). The ratiometric fluorometric assay, which is based on measuring the ratio of emissions (F/F), has a wide detection range of 5-2000 ng /mL and a limit of detection (LOD, S/N = 3) of 1.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!