Five Predictors of Methotrexate Failure in Rheumatoid Arthritis

Aug 21, 2018

Which clinical and psychosocial factors have been implicated in a lack of response to MTX?

Reference1. Sergeant JC, Hyrich KL, Anderson J, et al. Prediction of primary non-response to methotrexate therapy using demographic, clinical and psychosocial variables: results from the UK Rheumatoid Arthritis Medication Study (RAMS). Arthritis Res Ther. 2018;20:147. doi: 10.1186/s13075-018-1645-5.

Sergeant and fellow researchers at the University of Manchester in the UK found that high anxiety, rheumatoid factor (RF) negativity, high tender joint counts, low disease activity scores, and high Health Assessment Questionnaire scores predict non-response to methotrexate (MTX) therapy.¹ Thumb through the slides for the details of the study and the take-home points for clinicians.

RA, rheumatoid arthritis.

EULAR, European League Against Rheumatism; MTX, methotrexate; RA, rheumatoid arthritis; RF, rheumatoid factor.

The Rheumatoid Arthritis Medication Study (RAMS), a large multicenter observational trial, enrolled patients with RA or undifferentiated polyarthritis who were starting to use MTX for the first time.

CI, confidence interval; DAS28, Disease Activity Score based on the 28-joint count; HADS, Hospital Anxiety and Depression Scale; HAQ, Health Assessment Questionnaire; MTX, methotrexate; RF, rheumatoid factor.

BMI, body mass index; DAS28, Disease Activity Score based on the 28-joint count; HADS, Hospital Anxiety and Depression Scale; HAQ, Health Assessment Questionnaire; TJC28, tender 28-joint count.

HADS, Hospital Anxiety and Depression Scale; HAQ, Health Assessment Questionnaire; MTX, methotrexate; RA, rheumatoid arthritis; RF, rheumatoid factor.