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Review
. 2019 Jan;178(1):17-20.
doi: 10.1007/s00431-018-3286-8. Epub 2018 Nov 17.

The effect of repeated methotrexate injections on the quality of life of children with rheumatic diseases

Justin Jacobse  1   2   3 , Wouter Ten Voorde  2   3 , Robert Rissmann  2   3 , Jacobus Burggraaf  2   3 , Rebecca Ten Cate  1 , Lenneke Schrier  4
Affiliations
Review

The effect of repeated methotrexate injections on the quality of life of children with rheumatic diseases

Justin Jacobse et al. Eur J Pediatr. 2019 Jan.

Abstract

In clinical practice, the burden of repeated injections in children with rheumatic disease receiving disease-modifying anti-rheumatic drugs is significant. To investigate the nature and extent of impact on the quality of life after repeated injections, we conducted a literature review. Two relevant papers were identified, both about children with juvenile idiopathic arthritis (JIA) being administered methotrexate. The results suggest that the combination of needle fear, impact of methotrexate treatment, and procedural consequences, e.g., blood sampling, all contribute to the distress and the loss of quality of life of children with JIA. Remarkably, no studies examining fear of injections or injection pain in children with rheumatic diseases receiving biologicals were identified.Conclusion: Strategies to optimize administration of disease modifying anti-rheumatic drugs should be systematically investigated. What is Known: • Repeated parenteral administration of drugs is burdensome for children with rheumatic diseases. What is New: • Needle fear should be investigated systematically to optimize administration of disease-modifying anti-rheumatic drugs.

Keywords: Biologicals; Fear of needles; Injection pain; Juvenile idiopathic arthritis; Parental drugs.

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Conflict of interest statement

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

The authors declare that they have no conflict of interest.

References

    1. Agras S, Sylvester D, Oliveau D. The epidemiology of common fears and phobia. Compr Psychiatry. 1969;10(2):151–156. doi: 10.1016/0010-440X(69)90022-4. - DOI - PubMed
    1. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. Washington, DC. 10.1176/appi.books.9780890425596
    1. Bienvenu OJ, Eaton WW. The epidemiology of blood-injection-injury phobia. Psychol Med. 1998;28(5):1129–1136. doi: 10.1017/S0033291798007144. - DOI - PubMed
    1. Bromberg MH, Connelly M, Anthony KK, Gil KM, Schanberg LE. Self-reported pain and disease symptoms persist in juvenile idiopathic arthritis despite treatment advances: an electronic diary study. Arthritis Rheum. 2014;66(2):462–469. doi: 10.1002/art.38223. - DOI - PMC - PubMed
    1. Bulatović M, Heijstek MW, Verkaaik M, Van Dijkhuizen EHP, Armbrust W, Hoppenreijs EPA, et al. High prevalence of methotrexate intolerance in juvenile idiopathic arthritis: development and validation of a methotrexate intolerance severity score. Arthritis Rheum. 2011;63(7):2007–2013. doi: 10.1002/art.30367. - DOI - PubMed

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