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.
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http://dx.doi.org/10.1002/acr.25141 | DOI Listing |
Br J Clin Pharmacol
November 2024
University of South Australia (UniSA: Clinical and Health Sciences, Centre for Pharmaceutical Innovation), Adelaide, South Australia, Australia.
Br J Clin Pharmacol
June 2024
Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
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.
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 PDFJ Pharm Biomed Anal
January 2024
Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Assiut University, Assiut, Egypt. Electronic address:
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.
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