THỰC TRẠNG ĐIỀU TRỊ METHOTREXATE Ở BỆNH NHÂN VIÊM KHỚP DẠNG THẤP TẠI TRUNG TÂM CƠ XƯƠNG KHỚP BỆNH VIỆN BẠCH MAI

Abstract

Objective: Current Status of Methotrexate Treatment and Factors Associated with Dose Modification in Patients with Rheumatoid Arthritis at the Musculoskeletal Center – Bach Mai Hospital. Subjects  and  Methods: To describe the current status of methotrexate (MTX) treatment and identify factors associated with MTX dose modification in patients with rheumatoid arthritis (RA). A cross-sectional, retrospective combined with prospective descriptive study was conducted on 168 patients diagnosed with RA according to the ACR 1987 or EULAR/ACR 2010 criteria and treated with MTX at the Musculoskeletal Center, Bach Mai Hospital, from August 2024 to July 2025. Results: The mean age of participants was 54.5 ± 12.44 years, with a predominance of female patients (79.17%). The mean disease duration was 4.9 ± 4.35 years. The average weekly MTX dose was 14.6 ± 2.2 mg. MTX dose reduction was observed in 35.7% of patients, mainly due to good therapeutic response (78.3%) and adverse effects (20.3%). Dose escalation occurred in 14.3% of patients, primarily due to partial response (88.9%), corticosteroid overuse (29.6%), and limited disease understanding (8.3%). Patients in the dose reduction group had lower disease activity levels and a higher rate of biologic DMARD use compared to those without dose reduction, with statistically significant differences (p < 0.05). Conclusion: Good therapeutic response was the primary reason for MTX dose reduction. The average MTX dose was 14.6 ± 2.2 mg/week. Lower disease activity and the use of bDMARDs were associated with a higher likelihood of MTX dose reduction.