Patient perspectives on simultaneous methotrexate-folic acid intake to improve adherence in rheumatoid arthritis: a cross-sectional survey.
4 affiliations
- 1SAINBIOSE U1059, University of Jean Monnet Saint-Etienne, Mines Saint-Etienne, INSERM, Saint-Etienne, France.
- 2Sanoïa, e-Health Services, Aubagne, France.
- 3AFPric (Association Française des Polyarthritiques et des Rhumatismes Inflammatoires Chroniques), Paris, France.
- 4Department of Rheumatology, SAINBIOSE U1059, University of Jean Monnet Saint-Etienne, CHU Saint-Etienne, Mines Saint-Etienne, INSERM, Saint-Etienne, France.
Abstract
Objective
To assess real-world adherence to folic acid (FA) supplementation with methotrexate (MTX) and patient perceptions of a simplified, same-day dosing strategy in RA.Methods
We conducted a cross-sectional online survey co-designed with patient representatives and distributed by the French patient association AFPric. RA patients treated with MTX were eligible. The questionnaire captured MTX and FA regimens, omissions, adverse events and attitudes toward same-day MTX and FA administration. Analyses were descriptive with prespecified subgroup comparisons.Results
Among 967 respondents (86.8% women; mean age 62.4 years), 86.7% reported once-weekly FA supplementation. Overall, 25.5% reported at least occasional FA omission, with omissions more frequent among long-term MTX users. Nausea after MTX was reported by 46.6% of respondents and by 52.6% of those reporting FA omissions. A same-day MTX and FA regimen was perceived as simpler by 30.5% and 41.5% believed it could reduce FA omission. Overall, 64.8% indicated that they would be willing to participate in a randomised controlled trial evaluating simultaneous administration.Conclusion
One in four people with RA treated with MTX reported FA omissions. Many respondents believed that a same-day regimen could reduce FA omissions, and interest in participating in a clinical trial was high. These findings support the feasibility of prospectively evaluating whether same-day MTX and FA administration may improve adherence and tolerability in selected patients, particularly those receiving once-weekly FA supplementation, without compromising MTX effectiveness.
Related
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- Machine Learning Models to Predict Methotrexate Treatment Response in Rheumatoid Arthritis: A Scoping Review
- Diagnostic performance of FIB-4 in detecting advanced liver fibrosis in patients with rheumatoid arthritis, psoriatic arthritis and psoriasis using methotrexate.
- Targeting the NLRP3 inflammasome in rheumatoid arthritis fibroblast-like synoviocytes: pathogenic mechanisms, therapeutic strategies, and translational perspectives
BibTeX
@article{dalix2026patient,
title = {{Patient perspectives on simultaneous methotrexate-folic acid intake to improve adherence in rheumatoid arthritis: a cross-sectional survey.}},
author = {Elisa Dalix and Naïma Hamamouche and Irène Pico Philippe and Sandrine Rollot and Hubert Marotte},
journal = {Rheumatology advances in practice},
year = {2026},
month = oct,
doi = {10.1093/rap/rkag109},
url = {https://europepmc.org/article/MED/42861272},
note = {CC BY},
}
RIS
TY - JOUR
TI - Patient perspectives on simultaneous methotrexate-folic acid intake to improve adherence in rheumatoid arthritis: a cross-sectional survey.
AU - Elisa Dalix
AU - Naïma Hamamouche
AU - Irène Pico Philippe
AU - Sandrine Rollot
AU - Hubert Marotte
PY - 2026
DA - 2026/10/08
JO - Rheumatology advances in practice
DO - 10.1093/rap/rkag109
UR - https://europepmc.org/article/MED/42861272
AB - Objective To assess real-world adherence to folic acid (FA) supplementation with methotrexate (MTX) and patient perceptions of a simplified, same-day dosing strategy in RA.Methods We conducted a cross-sectional online survey co-designed with patient representatives and distributed by the French patient association AFPric. RA patients treated with MTX were eligible. The questionnaire captured MTX and FA regimens, omissions, adverse events and attitudes toward same-day MTX and FA administration. Analyses were descriptive with prespecified subgroup comparisons.Results Among 967 respondents (86.8% women; mean age 62.4 years), 86.7% reported once-weekly FA supplementation. Overall, 25.5% reported at least occasional FA omission, with omissions more frequent among long-term MTX users. Nausea after MTX was reported by 46.6% of respondents and by 52.6% of those reporting FA omissions. A same-day MTX and FA regimen was perceived as simpler by 30.5% and 41.5% believed it could reduce FA omission. Overall, 64.8% indicated that they would be willing to participate in a randomised controlled trial evaluating simultaneous administration.Conclusion One in four people with RA treated with MTX reported FA omissions. Many respondents believed that a same-day regimen could reduce FA omissions, and interest in participating in a clinical trial was high. These findings support the feasibility of prospectively evaluating whether same-day MTX and FA administration may improve adherence and tolerability in selected patients, particularly those receiving once-weekly FA supplementation, without compromising MTX effectiveness.
SN - 2514-1775
ER -