Respuesta clínica y adherencia al tratamiento con metotrexato en pacientes atendidos en el Hospital “Arnaldo Milián Castro” en el año 2020
Fecha
2021
Autores
Jiménez Peña, Yaime
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Universidad Central ‘‘Marta Abreu’’ de Las Villas. Facultad de Química y Farmacia. Departamento de Farmacia
Resumen
La artritis reumatoide es una enfermedad inflamatoria autoinmune crónica de origen desconocido. El metotrexato, antirreumático modificador de la enfermedad, constituye el tratamiento de primera línea para esta patología. Con el objetivo de evaluar la respuesta clínica y adherencia al tratamiento con este fármaco en pacientes atendidos en el servicio de Reumatología del Hospital ¨Arnaldo Milián Castro¨ en el año 2020, se desarrolló un estudio descriptivo, observacional y retrospectivo, seleccionándose una muestra de 315 pacientes. La artritis reumatoide fue el principal motivo de indicación del fármaco, observándose un consumo mensual de 61042 tabletas, con una dosis diaria definida de 0,31mg. En la muestra seleccionada predominaron las mujeres, con edad promedio de 59 años, probablemente debido a influencias hormonales. La hipertensión arterial, la diabetes mellitus y el asma bronquial resultaron ser las comorbilidades más frecuentes y entre los hábitos tóxicos, el consumo de café y tabaco. El nivel universitario coincidió con el menor número de casos diagnosticados (18,73%), mientras que los trabajadores resultaron ser los más expuestos (50,15%). Los principales eventos adversos identificados fueron gastrointestinales, así como un aumento significativo de las transaminasas y las interacciones con AINEs resultaron ser las de mayor incidencia. La respuesta clínica fue más favorable cuando el metotrexato se empleó en terapia combinada con otros fármacos y se evidenció una alta adherencia al tratamiento (mayor del 80%) lo que pudiera estar relacionado con la gran sobrevida a la medicación observada en estos pacientes.
Rheumatoid arthritis is a chronic autoimmune inflammatory disease of unknown origin. Methotrexate, a disease-modifying antirheumatic drug, is the first-line treatment for this condition. In order to evaluate the clinical response and adherence to treatment with this drug in patients treated at the Rheumatology service of the ¨Arnaldo Milián Castro¨ Hospital in 2020, a descriptive, observational and retrospective study was developed, selecting a sample of 315 patients. Rheumatoid arthritis was the main reason for indicating the drug, with a monthly consumption of 61,042 tablets, with a defined daily dose of 0.31mg. In the selected sample, women predominated, with an average age of 59 years, probably due to hormonal influences. Hypertension, diabetes mellitus and bronchial asthma were the most frequent comorbidities and among toxic habits, coffee and tobacco consumption. The university level coincided with the lowest number of diagnosed cases (18.73%), while workers were the most exposed (50.15%). The main adverse events identified were gastrointestinal, as well as a significant increase in transaminases and interactions with NSAIDs were those with the highest incidence. The clinical response was more favorable when methotrexate was used in combination therapy with other drugs and a high adherence to treatment (greater than 80%) was evidenced, which could be related to the long survival to the medication observed in these patients.
Rheumatoid arthritis is a chronic autoimmune inflammatory disease of unknown origin. Methotrexate, a disease-modifying antirheumatic drug, is the first-line treatment for this condition. In order to evaluate the clinical response and adherence to treatment with this drug in patients treated at the Rheumatology service of the ¨Arnaldo Milián Castro¨ Hospital in 2020, a descriptive, observational and retrospective study was developed, selecting a sample of 315 patients. Rheumatoid arthritis was the main reason for indicating the drug, with a monthly consumption of 61,042 tablets, with a defined daily dose of 0.31mg. In the selected sample, women predominated, with an average age of 59 years, probably due to hormonal influences. Hypertension, diabetes mellitus and bronchial asthma were the most frequent comorbidities and among toxic habits, coffee and tobacco consumption. The university level coincided with the lowest number of diagnosed cases (18.73%), while workers were the most exposed (50.15%). The main adverse events identified were gastrointestinal, as well as a significant increase in transaminases and interactions with NSAIDs were those with the highest incidence. The clinical response was more favorable when methotrexate was used in combination therapy with other drugs and a high adherence to treatment (greater than 80%) was evidenced, which could be related to the long survival to the medication observed in these patients.
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Metotrexato