Methotrexate intoxication: Beyond the adverse events

• Published in: International journal of rheumatic diseases Vol. 21; no. 8; pp. 1557 - 1562
• Main Authors: Dalkilic, Ediz, Coskun, Belkıs Nihan, Yağız, Burcu, Tufan, Ayşe Nur, Ermurat, Selime, Pehlivan, Yavuz
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.08.2018
• Subjects: Adult; Aged; Aged, 80 and over; Antirheumatic Agents - administration & dosage; Antirheumatic Agents - poisoning; Arthritis, Rheumatoid - drug therapy; Communicable Diseases - chemically induced; Communicable Diseases - mortality; Communicable Diseases - therapy; Dose-Response Relationship, Drug; Drug Interactions; Female; Fever; Fever - chemically induced; Fever - mortality; Fever - therapy; Humans; Inflammatory diseases; Intoxication; Male; Medication Errors; Methotrexate; Methotrexate - administration & dosage; Methotrexate - poisoning; methotrexate toxicity; Middle Aged; Mucositis; Mucositis - chemically induced; Mucositis - diagnosis; Mucositis - mortality; Mucositis - therapy; Nausea; Patients; Purpura, Thrombocytopenic - chemically induced; Renal insufficiency; Renal Insufficiency - chemically induced; Renal Insufficiency - mortality; Renal Insufficiency - therapy; Retrospective Studies; Rheumatoid arthritis; Risk Assessment; Risk Factors; Toxicity; Turkey; methotrexate; renal insufficiency; methotrexate toxicity
• ISSN: 1756-1841; 1756-185X
• DOI: 10.1111/1756-185X.13339

Aim Methotrexate (MTX) is the first‐line disease‐modifying antirheumatic drug in rheumatoid arthritis (RA). However, this anchor may cause some side effects that may range from nausea to mortality. The clinical features of MTX toxicity are under‐researched. In this study, we aimed to find out the potential predisposing factors and outcomes of the MTX toxicity (n = 31). Methods The data were collected from 31 patients whose ages ranged from 25 to 81 years, who were suffering from immune‐mediated inflammatory diseases and major MTX‐related toxicity. Results Out of 31 patients, six (19.4%) used MTX every day, and 13 (41.9%) patients had renal insufficiency who were admitted to the hospital because of mucositis (90.3%) and fever (71%). While using MTX, 27 patients (87.1%) were discharged after the treatment and four patients (12.9%) died. Conclusions Although MTX has high efficacy for the toxicity ratio, wrong use and dosage of MTX may be harmful to patients. Thus, patients should be informed about the proper use of MTX.