Prescribing Patterns of Methotrexate in Libyan Patients with Rheumatoid Arthritis

Chronic rheumatoid arthritis (RA) is a systemic inflammatory disease that leads to cartilage and bone erosion. Untreated disease is linked with joint deformity and substantial health care related costs. Conventional disease-modifying anti-rheumatic drugs (DMARDs) are the main tool to treat any form of RA. Methotrexate (MTX) is the key conventional DMARDs. It is recommended as a first-line treatment for patients with RA. However, MTX is potentially associated with various toxicities. No clear pattern of MTX use in patients with RA in Libya, since no national guideline has been implanted so far. The aim was to investigate the prescribing patterns of MTX in Libya. A hundred and twenty patients who were on treatment with MTX and follow up in RA clinic of Tripoli University hospital were evaluated for therapy during the period of 2018 and 2019. Patient distribution data, disease duration, other related diseases and drug prescribed as well as adverse drug reactions were considered to analyze the pattern of drug use. The demographic distribution findings indicate that female patients are more than male patients and the ratio of disease among female to male was 1:9. A range of age between 41 - 60 years was the highest affected compared with other ages. Among of these about 75% of patients were no occupational works. RA related diseases were found to be more with diabetes mellitus, hypertension and osteoporosis. Low use of NSAIDs in this group of patients but with high use of steroid. A high group of patient's use of low dose of MTX for up to five years. This study concludes that MTX is an effective drug in controlling the disease with less and tolerated incidence of side effects.