Predictors of Response to Methotrexate Naïve Female Patients with Rheumatoid Arthritis

Objective: To see the factors that affect response to Methotrexate in female patients with rheumatoid arthritis. Study design: Prospective longitudinal study. Place and Duration of Study: Department of Rheumatology, Fauji Foundation Hospital (FFH), Rawalpindi Pakistan, from Nov 2019 to Jan 2020 Methodology: Rheumatoid arthritis patients 18 to 75 years of age, 115 in number all females were selected from rheumatology outpatient department (OPD) at FFH, Rawalpindi. All patients in the study were started on Methotrexate first time. Patients were assessed at baseline and after three months. At week 0 and week 12 Disease Activity score 28(DAS28), Clinical Disease Activity Index (CDAI) and Pain Visual Analogue Scale (VAS) was calculated. Inflammatory markers were measured in blood samples. SPSS version 23.0 was used for data interpretation. Results: About 115 were the total patients included in the study, with a mean age (in years) of 50.63±10.50. Association between response to Methotrexate and age shows that age <50 shows good response to Methotrexate in 54% while 51.7% shows good response to Methotrexate in patient’s age >50 years (p-value 0.754). Non-smokers have 55.3% good response as compared to 33.7% in smokers (p-value 0.128). Sero-negativity in Rheumatoid arthritis shows a EULAR good response in 65% of patients while only 44% in seropositive Rheumatoid arthritis (p-value 0.024) Conclusion: In females current smoking, seropositive status predicts worse response to Methotrexate while age, comorbidities and occupation have no impact on response to Methotrexate.