METHOFRACT, a methotrexate osteopathy multicentre cohort study
Abstrak
Methotrexate-induced osteopathy (MTX-IO) is a rare condition typically involving the lower limbs, especially tibia or foot fractures, among patients with well-controlled rheumatoid arthritis (RA) or psoriatic arthritis (PsA). This study aimed to identify the affected population, describe fracture characteristics and identify risk factors for poor clinical outcome. A multicentre retrospective study included patients with MTX-IO diagnosed by bone specialists or identified through French pharmacovigilance. The data collected included clinical presentation, imaging features, bone mineral density and biochemical markers. Between 2012 and 2024, 92 patients were included, predominantly postmenopausal women with seropositive RA. A history of major fractures was noted for 22% of the patients, and 56% presented osteoporosis at diagnosis. Fractures were most common in the tibial metaphysis (distal and proximal) (88%) and the foot bones (49%), with multiple fractures often present at diagnosis (76%), and frequently repeated fractures in the patients’ recent histories (63%). Diagnosis was conducted using MRI of the painful sites (84%), but bone scintigraphy was also used (41 patients, 45%). Management involved methotrexate discontinuation in 79% of the cases. Fracture healing and pain relief were achieved in 77% of the cases, with a significant difference in outcomes between those who discontinued methotrexate (91%) versus those who continued (29%) (p<0.001). MTX-IO is a rare but significant condition, especially among postmenopausal women with RA or PsA. Early diagnoses via MRI or bone scintigraphy and the discontinuation of methotrexate are critical, as stopping the drug significantly improves outcomes and prevents further fractures.
Topik & Kata Kunci
Penulis (37)
Karine Briot
Rose-Marie Javier
Emmanuel Chatelus
Thierry Schaeverbeke
Guillaume Coiffier
Bernard Cortet
Julia Nicolau
Olivier Malaise
Nadia Mehsen-Cetre
Isabelle Roitg
Jean-Philippe Hauzeur
Beatrice Bouvard
Charles Ghiringhelli
Eugénie Koumakis
Roba Ghossan
Pascal Guggenbuhl
Cécile-Audrey Durel
Marie Eva Pickering
Guillaume Larid
François Robin
Julien Paccou
Louise Triquet
Maëva Masson
Emmanuel Massy
Marine Mina
Claire Barthe
Julien Herman
Martine Branquet
Julien Lasnier Siron
Manon Guillouard
Camille Desmonet Trousset
Aurore Aubrun
Bertrand Godfrin
Jean-Louis Legrand
Alexia Leloix
Marijke Decrock
Charlotte Casadepax-Soulet
Akses Cepat
PDF tidak tersedia langsung
Cek di sumber asli →- Tahun Terbit
- 2025
- Sumber Database
- DOAJ
- DOI
- 10.1136/rmdopen-2025-005941
- Akses
- Open Access ✓