ABSTRACT Background Methotrexate (MTX) remains the cornerstone therapy for rheumatoid arthritis (RA); however, adverse events such as oral mucositis are underreported in real‐world settings. The aim of this study was to examine the prevalence, severity, patient self‐management, and involvement of healthcare providers in MTX‐induced oral mucositis among RA outpatients. Methods A questionnaire‐based study was conducted between October and December 2024, targeting patients with RA receiving MTX who visited community pharmacies. Patients aged ≥ 20 years were asked to complete an 18‐item questionnaire assessing the incidence, severity (graded by the Common Terminology Criteria for Adverse Events v5.0), timing, management, and impact of oral mucositis, as well as communication with physicians, dentists, and pharmacists. Results Among the 101 valid responses, 26.7% of the patients experienced oral mucositis, and 41.6% reported either mucositis or oral discomfort. Of those with mucositis, 64% had grade ≥ 2 severity, and 63% implemented some form of countermeasure—most commonly the use of mouthwash or over‐the‐counter medications. However, 37% of the patients did not take any action; only 55.6% consulted healthcare professionals, mainly physicians or dentists, whereas none consulted a pharmacist. Communication gaps between patients and dental care professionals were noted. Conclusion These findings suggest a higher prevalence of MTX‐induced oral mucositis than that previously reported in randomized controlled trials. Despite its clinical impact, the management of MTX‐induced oral mucositis remains inconsistent, with many patients not seeking support. Enhanced interprofessional collaboration and proactive patient education, especially involving pharmacists and dentists, are essential for the continuity of MTX therapy in RA and improving adverse event monitoring.
Kiyomi et al. (Thu,) studied this question.