Ab0710 Should I Take a Tablet or Give Myself an Injection? Patients’ Perspective on the Choice of the Administration of Methotrexate (Mtx) in Rheumatoid Arthritis (Ra)

Background: Although many new targeted therapies for rheumatoid arthritis (RA) have been developed in recent years, methotrexate has remained the "anchor drug" for most patients since the late 1980s.[1]. The presence of a gap between the real preferences of patients in RA and the perception of rheumatologists shows that it is important to take into account the patient's point of view in the decision-making process for choosing the path administration of the treatment in particular MTX. Objectives: To evaluate how patients with rheumatoid arthritis (RA) consider taking disease-modifying treatment (MTX) orally or by injection. Methods: A cross-sectional study was carried out at the rheumatology department of Marrakech University Hospital including 92 patients suffering from RA according to the ACR/EULAR 2010 criteria treated with MTX. All patients included were on oral or injectable MTX. Epidemiological and clinical data were collected. We assessed patients' views regarding the reasons or factors motivating their choice by questionnaire which is distributed over 11 items and which allows the evaluation of 5 areas: Efficiency Side effects convenience Cost Doctor's opinion The analysis was carried out using SPSS version 21 software; a statistically significant covariate was considered if p <0.05. Results: Our population was predominantly female (81 women and 11 men),middle aged 49.58±12.34 [23-77]years and with a duration of RA < 10 years in 77.1% of cases.RA was immune positive in 79 patients. (46.7%) patients had at least one comorbidity. The average DAS(28) was 4.04± 1.94 [1-7.60]. The patients were distributed as follows according to RA activity: 17 (18.5%) patients in remission, 16 patients (17.4%) in low activity, 23 patients (25%) in moderate activity and 36 patients (39.1%) in high activity. 67.4% of patients took MTX by injection and 32.6% took it orally.MTX was associated with corticosteroid therapy in 55.4% and biotherapies in 15.2% of participants. The areas were chosen in the following order: Doctor's opinion 21.7% effectiveness 19.6%; Other treatments/comorbidities/other patients' experiences/effects on other patients 18.5%, Side effects/fear of side effects 14.1%, Cost 9.8%, Ease/frequency of administration 8.7%, and fear of needles 7.6%. A highly significant correlation was found between the choice of route of administration and the presence of comorbidities (with a correlation coefficient: r = 0.943 p < 0.039). Patients over 50 years old and with comorbidities more preferred the oral route. The choice of the oral route was linked to the duration of the disease (p=0.05). Conclusion: We identified the patients' point of view regarding the choice between oral MTX and injectable MTX during RA. This information can facilitate shared decision-making regarding the choice of route of administration of MTX in RA. REFERENCES: [1] Weinblatt ME, Coblyn JS, Fox DA, et al. Efficacy of low-dose methotrexate in rheumatoid arthritis. N Engl J Med1985;312:818–22. Acknowledgements: NIL. Disclosure of Interests: None declared.