medigraphic.com
SPANISH

Revista ADM Órgano Oficial de la Asociación Dental Mexicana

ISSN 0001-0944 (Print)
Órgano Oficial de la Asociación Dental Mexicana
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
    • Send manuscript
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2024, Number 1

<< Back Next >>

Rev ADM 2024; 81 (1)

Oral mucositis as an adverse effect of the use of methotrexate in the treatment of rheumatoid arthritis: a systematized review of cases.

Salgado MY, González MM, Almazo SD
Full text How to cite this article 10.35366/114746

DOI

DOI: 10.35366/114746
URL: https://dx.doi.org/10.35366/114746

Language: Spanish
References: 71
Page: 44-54
PDF size: 258.64 Kb.


Key words:

arthritis, mucositis, inflammation, methotrexate, pathology.

ABSTRACT

Introduction: methotrexate is widely used for the treatment of a variety of neoplastic and autoimmune diseases. However, like all drugs its efficacy is marked by a certain degree of toxicity due to the pharmacokinetics of the drug. Methotrexate was developed as an anticancer drug, however, it has become the treatment of choice for rheumatoid arthritis. Methotrexate primarily causes inflammation of the epithelial mucous membranes. Most of the side effects of methotrexate can be detected early and are reversible. Mucositis of the alimentary tract is the main side effect of cancer chemotherapy. It is collectively known as chemotherapy-induced mucosal injury, affecting the entire alimentary canal from the mouth to the anus, where oral mucositis and intestinal mucositis are both common. Material and methods: we searched for clinical cases reporting mucositis caused by methotrexate in the treatment of rheumatoid arthritis, using a modified PRISMA flowchart to search for articles. Finally, the clinical cases were checked for compliance with the fundamentals of the CARE guide, in order to manage a correct approach to oral medicine. It is important to inquire about the diseases the patients present, as well as the history of medications administered, especially in older patients, with more systemic disease conditions, structure, and low risk of bias. Conclusion: a correct anamnesis and oral clinical examination is the most important aspect of oral medicine. It is important to inquire about the diseases that the patients present, as well as the history of medications that are administered, especially in older patients with major systemic diseases.


REFERENCES

  1. World Health Organization. Rheumatoid arthritis. News Room. Geneva: WHO; 2023. Available in: https://www.who.int/news-room/fact-sheets/detail/rheumatoid-arthritis#:~:text=Overview,lung%20or%20nervous%20system%20problems

  2. Global Burden of Disease. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis. Global Burden of Disease Study; 2019. Available in: https://vizhub.healthdata.org/gbd-results/..

  3. Peláez-Ballestas I, Sanin LH, Moreno-Montoya J, Alvarez-Nemegyei J, Burgos-Vargas R, Garza-Elizondo M, et al. Epidemiology of the rheumatic diseases in Mexico. A study of 5 regions based on the COPCORD methodology. J Rheumatol Suppl. 2011; 86: 3-8.

  4. Alban Fierro PE, Carvajal Santana GE, Simbaña Paucar FM. Artritis reumatoide: una visión general. Revista Cubana de Reumatología. 2022; 24 (2): 1020.

  5. Chauhan K, Jandu JS, Brent LH, Al-Dhahir MA. Rheumatoid arthritis. 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.

  6. Ajmani S, Preet Singh Y, Prasad S, Chowdhury A, Aggarwal A, Lawrence A et al. Methotrexate-induced pancytopenia: a case series of 46 patients. Int J Rheum Dis. 2017; 20 (7): 846-851.

  7. Olivares Martínez E, Hernández Ramírez DF, Núñez-Álvarez CA, Cabiedes J. Proteínas citrulinadas en artritis reumatoide. Reumatol Clin. 2011; 7 (1): 68-71.

  8. Martínez-Téllez G. Relación de los alelos HLA-DRB1 con respuesta terapéutica en la artritis reumatoide. Una revisión sistemática. Revista Cubana de Genética Comunitaria. 2022; 14 (1): e140.

  9. Fox D. Etiology of rheumatoid arthritis: a historical and evidence-based perspective. Springer International Publishing. 2016; 13 (1): 9.

  10. Arce-Salinas CA, Arriaga-Caraza HA, Paz-Viscarra AA, Comellas-Kirkup L, Alexandre-Mendoca J, Díaz-Galicia Y et al. Evaluación de cambios ultrasonográficos tempranos con el sistema de puntuación Global OMERACT-EULA (GLOESS) en pacientes con artritis reumatoide que inician tratamiento con inhibidores del factor de necrosis tumoral. Med Int Méx. 2022; 38 (4): 811-819.

  11. Gómez-Reino Carnota JJ. El papel del factor de necrosis tumoral en la inflamación y el daño articular en la artritis reumatoide. Rev Esp Reumatol. 2002; 1 Supl 2: 2-4.

  12. Feria Díaz G. Papel de las citoquinas en la fisiopatología de la artritis reumatoide. Correo Científico Médico. 2020; 24 (1): 341-360.

  13. Lee K, Achuthan A, Hamilton J. GM-CSF: a promising target in inflammation and autoimmunity. Immunotargets Ther. 2020; 29 (1): 225-240.

  14. Lee K, Jarnicki A, Achuthan A, Fleetwood A, Anderson G, Ellson C. CCL17 in inflammation and pain. J Immunol. 2020; 205 (1): 213-222.

  15. Salman LA, Ahmed G, Dakin SG et al. Osteoarthritis: a narrative review of molecular approaches to disease management. Arthritis Res Ther. 2023; 25 (27): 1-9.

  16. Zhang Y, Sun L, Chen X. A systematic review of population pharmacokinetic models of methotrexate. Eur J Drug Metab Pharmacokinet. 2022; 47 (1): 143-164.

  17. Damerau A, Gaber T. Modeling rheumatoid arthritis in vitro: from experimental feasibility to physiological proximity. Int J Mol Sci. 2020; 21 (21): 7916.

  18. Conforti A, Di Cola I, Pavlych V, Ruscitti P, Berardicurti O, Ursini F et al. Beyond the joints, the extra-articular manifestations in rheumatoid arthritis. Autoimmun Rev. 2021; 20 (2): 102735.

  19. Cush J. Rheumatoid arthritis: early diagnosis and treatment. Med Clin. 2021; 105 (2): 355-365.

  20. Zhao H, Duan S, Shi Y, Zhang M, Zhang L, Jin Z et al. Naru-3 inhibits inflammation, synovial hyperplasia, and neovascularization in collagen-induced arthritis in rats. J Ethnopharmacol. 2023; 311: 116350.

  21. Fraenkel L, Bathon JM, England BR, St Clair EW, Arayssi T, Carandang K et al. 2021 American College of Rheumatology Guideline for the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2021; 73 (7): 924-939.

  22. Revenga Martínez M, Morán-Álvarez P, Arroyo-Palomo J, Valero Expósito M, Vázquez Díaz M. Artritis reumatoide. Medicine. 2021; 13 (30): 1669-1680.

  23. Kim EK, Kwon JE, Lee SY, Lee EJ, Kim DS, Moon SJ et al. IL-17-mediated mitochondrial dysfunction impairs apoptosis in rheumatoid arthritis synovial fibroblasts through activation of autophagy. Cell Death Dis. 2017; 8 (1): e2565.

  24. Tateiwa D, Yoshikawa H, Kaito T. Cartilage and bone destruction in arthritis: pathogenesis and treatment strategy: a literature review. Cells. 2019; 8 (8): 818.

  25. González-Costa M, Padrón GAA. La inflamación desde una perspectiva inmunológica: desafío a la Medicina en el siglo XXI. Rev Habanera Cienc Med. 2019; 18 (1): 30-44.

  26. Willkens RF, Watson MA. Methotrexate: a perspective of its use in the treatment of rheumatic diseases. J Lab Clin Med. 1982; 100 (3): 314-321.

  27. Toro-Gutiérrez C, Arbeláez-Cortés A, Fernández-Aldana A, Mejía-Romero R, Méndez-Patarroyo R, Quintana LG. Guía de práctica clínica para la detección temprana, el diagnóstico, el tratamiento y el seguimiento de los pacientes con artritis reumatoide. Asociación Colombiana de Reumatología, 2022. Rev Colomb Reumatol. 2023; 1-18.

  28. Alarcón-Payer C, Muñoz-Cid C, Claramunt-García R, Jiménez-Morales A. Manejo de altas dosis de metotrexato en un caso de leucemia aguda linfoblástica. Rev OFIL·ILAPHAR. 2022, 32 (4): 401-402.

  29. Amiri Khosroshahi R, Talebi S, Zeraattalab-Motlagh S, Imani H, Rashidi A, Travica N et al. Nutritional interventions for the prevention and treatment of cancer therapy-induced oral mucositis: an umbrella review of systematic reviews and meta-analysis. Nutr Rev. 2023; 81 (9): 1200-1212.

  30. Huang J, Hwang AYM, Jia Y, Kim B, Iskandar M, Mohammed AI et al. Experimental chemotherapy-induced mucositis: a scoping review guiding the design of suitable preclinical models. Int J Mol Sci. 2022; 23 (23): 15434.

  31. Burgos R, Suárez-Llanos JP, García-Almeida JM, Matía-Martín P, Palma S, Sanz-Paris A et al. Abordaje de la desnutrición en pacientes hospitalizados con diabetes/hiperglucemia y caquexia tumoral. Nutr Hosp. 2022; 39 (spe4): 40-46.

  32. Moreno-Zamora L, de Lucas-Castel L, Perandones-Cabello M. Mucositis. Revista Sanitaria de Investigación. 2023; 4 (8): 1-4.

  33. Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C et al. La declaración PRISMA 2020: una guía actualizada para informar revisiones sistemáticas. Rev Esp Cardiol. 2021; 74 (9): 790-799.

  34. Agha RA, Franchi T, Sohrabi C, Mathew G, Kerwan A, SCARE Group. The SCARE Guideline: Updating Consensus Surgical CAse REport (SCARE) guidelines. Int J Surg. 2020; S1743-9191 (20): 30771-30778.

  35. Gagnier J, Kienle G, Altman D, Moher D, Sox H, Riley D. The CARE guidelines: consensus-based clinical case reporting guideline development. J Clin Epidemiol. 2014; 67 (1): 46-51.

  36. Troeltzsch M, von Blohn G, Kriegelstein S, Woodlock T, Gassling V, Berndt R et al. Oral mucositis in patients receiving low-dose methotrexate therapy for rheumatoid arthritis: report of 2 cases and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013; 115 (5): e28-e33.

  37. Da Silva Mello EL, Limeira Feitosa MF, Pacheco Silva Filho MA, Ipólito Barros AM, Silva Pena NG, Farias De Albuquerque R et al. Oral mucositis caused by methotrexate in the treatment of psoriasis: case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 2022; 134 (3): e164.

  38. Verma M. Oral Mucositis induced by methotrexate: a case report. IHRJ. 2018; 2 (8): 195-196.

  39. Katsoulas N, Katsoulas N, Chrysomali E, Piperi E, Levidou G, Sklavounou-Andrikopoulou A. Atypical methotrexate-induced oral ulcers mimicking histopathologically a lymphoproliferative disorder: report of a rare case. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 120 (3): e152.

  40. De Brito NF, Da Silva BT, Amaral SM, Aguiar Miranda A, Pires FR, De Noronha S. Methotrexate-associated oral ulcers: a report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 126 (3): e82.

  41. Kunmongkolwut S, Amornkarnjanawat C, Phattarataratip E. Multifocal oral Epstein-Barr virus-positive mucocutaneous ulcers associated with dual methotrexate and leflunomide therapy: a case report. Eur J Dent. 2022; 16 (3): 703-709.

  42. Singh GK, Sapra D, Bahuguna A, Das P. Methotrexate toxicity in psoriasis-A multicentric retrospective study. Dermatol Ther. 2022; 35 (10): e15765.

  43. Da Silva AB, Garcia de Araújo dos Santos MR. Hyperbaric oxygen therapy as treatment for severe adverse events secondary to the methotrexate toxicity, case report. Braz J Hea Rev. 2022; 5 (1): 1935-1946.

  44. Cruz AC, Fidelis YP, Vieira LS, Figueiredo PT, Duarte DB, Lia EN. Methotrexate induced erythema multiforme: a case report of accidental overdose. Rev Bras Farm Hosp Serv Saude. 2021; 12 (3): 642.

  45. Sánchez-Romero ML, Cepeda-Bravo JA, Tejeda-Nava FJ, Delgado-Pastrana S, Aranda-Romo S. Estomatitis asociada a metotrexato: un reto diagnóstico. Int J Odontostomat. 2020; 14 (4): 572-574.

  46. Rocha LLA, Rodrigues MFB, Rocha CCL, Silva BA, Startari DM, Torres CVGR et al. Úlceras orais provocadas por metotrexato: Relato de caso. Braz J Dev. 2020; 6 (9): 70544-70552.

  47. Ventura AM, Fernandes MP, Franco F, Gomes AL. Intoxicacao por metotrexato: relato de caso. Revista Portuguesa De Medicina Geral E Familiar. 2020; 36 (6): 507-510.

  48. Gomes Carvalho C, Rodrigues Terrabuio B, Lemes Moura L, Rodrigues Manzano B, Simpione G, D'Aquino Garcia CR et al. Oral manifestations of erythema multiforme due to methotrexate intoxication. Int J Odontostomat. 2022; 16 (2): 195-201.

  49. Dervisoglou T, Matiakis A. Oral ulceration due to methotrexate treatment: a report of 3 cases and literature review. Balk J Dent Med. 2015; 19 (2): 116-120.

  50. Tugce Y, Mehmet Refik G, Mehmet S, Abdulmecit Y, Alparslan E. Low-dose methotrexate toxicity in a hemodialysis patient: a case report. Turk J Int Med. 2022; 4 (Supplement 1): S175-S177.

  51. Alhusayni KM, Alanazi IM, Dighriri IM, Alnazzawi AT, Rashed OA, Alharthi FM et al. A study of the clinical toxicity of methotrexate in the Taif region: a case report. IJMDC. 2023; 7 (4): 727-731.

  52. Rashid M, Zarkadas M, Anca A, Limeback H. Oral manifestations of celiac disease: a clinical guide for dentists. J Can Dent Assoc. 2011; 77: b39.

  53. Deeming GM, Collingwood J, Pemberton MN. Methotrexate and oral ulceration. Br Dent J. 2005; 198 (2): 83-85.

  54. Comité de Medicamentos de la Asociación Española de Pediatría AEP. Pediamécum. 2015. p. 1-6.

  55. Pérez HJC, Padilla OJ. Intoxicación por metotrexato en una paciente con artritis reumatoide. A propósito de un caso. Arch Med Urg Mex. 2012; 4 (3): 125-130.

  56. Maroñas-Jiménez L, Castellanos-González M, Sanz Bueno J, Vanaclocha Sebastián F. Erosiones y úlceras acrales: manifestación precoz de toxicidad aguda grave por metrotexato. Acta Otorrinolaringol Esp. 2014; 105 (3): 322-323.

  57. Miranda-Flores AF, Risco-Neyra R. Tratamiento del embarazo ectópico no complicado con inyección local de metotrexato. Ginecol Obstet Mex. 2022; 90 (9): 726-734.

  58. Kalantzis A, Marshman Z, Falconer DT, Morgan PR, Odell EW. Oral effects of low-dose methotrexate treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100 (1): 52-62.

  59. Cronstein BN, Aune TM. Methotrexate and its mechanisms of action in inflammatory arthritis. Nat Rev Rheumatol. 2020; 16 (3): 145-154.

  60. Schiff MH, Sadowski P. Oral to subcutaneous methotrexate dose-conversion strategy in the treatment of rheumatoid arthritis. Rheumatol Int. 2017; 37 (2): 213-218.

  61. Singh JA, Guyatt G, Ogdie A, Gladman DD, Deal C, Deodhar A et al. Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Rheumatol. 2019; 71 (1): 5-32.

  62. van Ede AE, Laan RF, Blom HJ, De Abreu RA, van de Putte LB. Methotrexate in rheumatoid arthritis: an update with focus on mechanisms involved in toxicity. Semin Arthritis Rheum. 1998; 27 (5): 277-292.

  63. Schnabel A, Gross WL. Low-dose methotrexate in rheumatic diseases--efficacy, side effects, and risk factors for side effects. Semin Arthritis Rheum. 1994; 23 (5): 310-327.

  64. McKendry RJ. The remarkable spectrum of methotrexate toxicities. Rheum Dis Clin North Am. 1997; 23 (4): 939-954.

  65. Berthelot JM, Maugars Y, Hamidou M, Chiffoleau A, Barrier J, Grolleau JY et al. Pancytopenia and severe cytopenia induced by low-dose methotrexate. Eight case-reports and a review of one hundred cases from the literature (with twenty-four deaths). Rev Rhum Engl Ed. 1995; 62 (7-8): 477-486.

  66. Restrepo LF, Giraldo R, Londoño J, Pinzón C, Cortes A, Ballesteros G et al. Farmacogenética del metotrexato en artritis reumatoide. Revisión sistemática. Rev Colomb Reumatol. 2016; 23 (2): 102-114.

  67. Otón T, Carmona L, Loza E, Rosario MP, Andreu JL. Use of parenteral methotrexate in rheumatic diseases: a systematic review. Reumatol Clin (Engl Ed). 2021; S1699-258X(20)30277-1.

  68. Chabner BA. Drug shortages--a critical challenge for the generic-drug market. N Engl J Med. 2011; 365 (23): 2147-2149.

  69. Jenks S. Efforts underway to curb drug shortages. J Natl Cancer Inst. 2011; 103 (12): 914-915.

  70. Hossein-Khannazer N, Kazem Arki M, Keramatinia A, Rezaei-Tavirani M. Low-level laser therapy for rheumatoid arthritis: a review of experimental approaches. J Lasers Med Sci. 2022; 13: e62.

  71. Fangel R, Vendrusculo-Fangel LM, Pires de Albuquerque C, Parizotto NA, dos Santos CC, Chieregato Matheus JP. Low level laser therapy for reducing pain in rheumatoid arthritis and osteoarthritis: a systematic review. Fisioter Mov. 2019; 32: e003229.




Figure 1
Figure 2
Table 1

2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev ADM. 2024;81