Impact of chronic low dose methotrexate treatment in rheumatoid arthritis on biochemical parameters in a population of eastern Algeria: A cross-sectional study

Abstract

Background: Lack of data describing biochemical parameters’ status in Algerian population during rheumatoid arthritis with long-term low dose methotrexate treatment.

Objectives: Evaluation of biochemical markers’ concentration and prevalence of values outside standards.

Patients and Methods: A cross-sectional study was conducted from October 2014 to March 2016 at Batna University Hospital, Algeria. Biochemical parameters’ assays were performed on Dimension RxL/Immulite 2000XPi and methotrexatemia determination on Unicel DxC600. Statistical tests were run on SPSS Statistics with a p value <0.05.

Results: A total of 91 patients were recruited with a M/F sex ratio of 0.30 and a median age of 49 years (36-59). All patients received a median methotrexate dosage of 15 mg/week with folinic acid supplementation in 71 patients. No significant differences in biochemical parameters concentration or disturbed values prevalence were noted between patients with at least one risk factor and those with none. Creatinine clearance was lower in patients with a methotrexate cumulative dose ≥ 1.5 g (p = 0.036). Disturbed creatinine clearance values (<80 mL/min) were noted only in female patients with a prevalence of 13.18%. Hyperhomocysteinemia (> 15 μmol/L) was found in 27.47% of study population with a higher prevalence of 47.82% during vitamin B12 deficiency.

Conclusion: Despite a good overall tolerance, it is recommended to monitor creatinine clearance especially in female patients and from a methotrexate cumulative dose exceeding 1.5 g. To avoid any atherosclerosis risk, periodic cardiovascular function monitoring, a blood count formula and a lipid profile should also be realized, particularly during vitamin B12 deficiency.