{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:04:14Z","timestamp":1790773454238,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T00:00:00Z","timestamp":1535587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to determine the influence of methotrexate (<jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content>) on gastrointestinal (<jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content>) symptoms in patients with rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional study examined 529 consecutive patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> receiving oral <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> in our department between April 1 and September 30, 2017. <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> symptoms were evaluated by the Gastrointestinal Symptom Rating Scale (<jats:styled-content style=\"fixed-case\">GSRS<\/jats:styled-content>); a score of \u22652 was considered \u201csymptomatic.\u201d Prevalence of <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> symptoms was compared between patients receiving \u22648\u00a0mg\/wk (low\u2010dose) vs &gt;8\u00a0mg\/wk (high\u2010dose) of <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of our study population, 313 (59%) received low\u2010dose <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> at a median (interquartile range) dose of 6 (6\u20108) mg\/wk, whereas 216 (41%) received high\u2010dose <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> at a median dose of 12 (10\u201012) mg\/wk. Relative to the low\u2010dose <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> group, the high\u2010dose <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> group exhibited a higher prevalence of reflux (32% vs 24%, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.043) and abdominal pain (28% vs 18%, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.007). There was no significant group\u2010dependent difference in the prevalence of indigestion, diarrhea or constipation. Multivariate logistic regression analysis revealed that high\u2010dose <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> (&gt;8\u00a0mg\/wk) was independently associated with reflux (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>]: 1.62, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 1.07\u20102.43) and abdominal pain (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 1.60, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.04\u20102.43), and that the <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s for reflux and abdominal pain among those receiving high\u2010dose <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> (&gt;8\u00a0mg\/wk) were similar to those using nonsteroidal anti\u2010inflammatory drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High\u2010dose <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> is independently associated with the prevalence of upper <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> symptoms in Japanese patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.13380","type":"journal-article","created":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T03:08:34Z","timestamp":1535684914000},"page":"207-213","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Influence of methotrexate on gastrointestinal symptoms in patients with rheumatoid arthritis"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4030-8793","authenticated-orcid":false,"given":"Shuji","family":"Asai","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Nagoya University Graduate School of Medicine Nagoya 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