Tolérance du Méthotrexate au cours du traitement de la polyarthrite rhumatoïde à Cotonou (Bénin)

Background and Purpose: to evaluate the safety of methotrexate in the treatment of RA in Benin. Methods: descriptive and analytical cross-sectional study of follow-up patients in the rheumatology department of the CNHU-HKM of Cotonou for rheumatoid arthritis treated with methotrexate. The diagnosis of RA was based on the 2010 EULAR / ACR criteria. We evaluated patients' tolerance to methotrexate through socio-demographic, clinical and paraclinic parameters. The data collected were analyzed using Epidata and SPSS17.0. Results: forty-nine (49) patients with RA under methotrexate were evaluated. The mean age of the patients was 44.6 ± 14.1 [15-69] and the sex ratio was 0.14. Rheumatoid factor was present in 88%, anti-CCP antibodies were present in 69.20%. Methotrexate was given at a dose of 7.5 to 20 mg / week. Only 4 patients used the IM form of methotrexate. Forty-one patients (83.67%) had at least one effect on methotrexate. The main clinical complications identified were hepato-digestive (46.9%), general (38.8%) cutaneo-phaneria (20.4%), pleuro-pulmonary (10.2%). Paraclinically, it was mainly hematological (77.6%), hepatic (16.3%) and pulmonary (6.1%). Methotrexate was discontinued in 7 patients. Reduction of the dose was performed in 3 patients while a change of the pathway was used in 4 patients. Seronegative RAs developed more severe complications than seropositive patients with no statistically significant difference between the 2 groups (p >0.05). Conclusion: Methotrexate remains the cornerstone of RA treatment in Benin. However, its use can be the cause of often minor side effects that it will be necessary to know and manage in order to optimize the adherence of the treatment.