POS0679 A NEW QUESTIONNAIRE AND SCORE (MISA) FOR ASSESSING METHOTREXATE INTOLERANCE IN RHEUMATOID ARTHRITIS

Background: Methotrexate (MTX) intolerance refers to unpleasant symptoms that accompany use of MTX and may lead its discontinuation. However, it lacks a validated score in RA patients; with the only option being MISS which was for children not adults. Objectives: To develop validate questionnaire (s) measuring severity rheumatoid arthritis. Methods: A 10-item called ‘Methotrexate Intolerance Severity assessment Adults’ (MISA) 105 patients. calculated by adding scores first 7 questions (0 3 based on symptoms), last or 1); ranged from 0 24 (MISA score) assessed correctly classifying (compared an interview) ROC analysis. Its area-under-curve (AUC) compared Score’ (MISS), developed children. Subsequently, administered 414 patients assess prevalence associations intolerance. In addition, MISA cross-products score, (severity (1 3) x duration per week (0.5 days)) symptoms, assessing Results: initial phase, MTX≥6 months were included, majority female (87%), mean age 51 (13.4) years methotrexate dose 18.8±6 mg/week. Thirty-five (33%) found be intolerant interview. had good predictive ability (AUC 0.904), classify intolerance, better than 0.823) (Figure 1A). The optimal cut-off ≥1, sensitivity specificity 91.4% 84.3%. Using (≥1), 38.4% have intolerance: nausea, lethargy irritability common symptoms. 1B, C) On multivariable analysis, (OR 0.972) BMI 1.061) significant predictors (Table 1) cross product performed best, 0.899 (95% CI 0.831-0.966), higher AUC 0.847 0.768-0.927) 0.837 0.754-0.920). Conclusion: is arthritis, having accuracy (at ≥1), detect present more one-third patients, most common. Table 1. Baseline characteristics Variable All (n=414) Tolerant (n=255) Intolerant (n=159) p-value tol. vs ntol. P-value model Females, n (%) 370 (89) 231 (91) 139 (87) 0.31 Age, yrs, (SD) 50 (12.5) 51.2 (12.6) 48.2 (12.2) 0.016* 0.008** Duration RA, 10.0 (7.0) 10.8 (7.4) 9.6 (6.3) 0.168 BMI, Kg/m 2a , 24.0 (4.9) 23.6 24.6 (4.7) 0.107 0.03* RF positive b 300 (73) 191 (82) 109 (78) 0.29 CDAI, (±SD) 14.0 (11.8) 14 (12.1) 14.1 (11.4) 0.69 Dose MTX, mg/wk, 18.6 (5.6) (5.5) 18.7 (5.8) 0.83 Injectable 47 (11) 25 (10) 22 (14) 0.21 Use FA, 395 (95) 241 154 (97) 0.27 other DMARD, 272 (66) 160 (62) 112 (70) 0.11 HCQ 209 (51) 123 (48) 86 (54) 0.25 Prednisolone 156 (38) 87 (34) 69 (43) 0.058 antiemetics, 12 (3) 1 (0.5) 11 (7) <0.001 Available 262 372 Figure showing curve questionnaires (A), Bar diagram various (B), Box-and-whiskers plot (C). Disclosure Interests: None declared