Fauzia, Fara
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Pengaruh Terapi Metotreksat pada Pasien Artritis Reumatoid terhadap Penurunan Fungsi Kognitif: Meta-Analisis Berdasarkan Telaah Sistematik Fauzia, Fara; Prihartono, Nurhayati Adnan; Hidayat, Rudy; Araminta, Abirianti P.
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 2
Publisher : UI Scholars Hub

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Abstract

Introduction. Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease involving the joints disorder as the main manifestations. Methotrexate (MTX) is currently still the drug of choice for RA treatment due to the good clinical response. However, there was a case reported by the American Geriatric Society in 2015 regarding the presence of reversible dementia after treatment with low-dose oral methotrexate. This study aimed to identify the effect of MTX treatment on cognitive disorder in RA patients. Methods. The study protocol was registered with PROSPERO (CRD42023414937). A systematic literature search was conducted in Medline Embase database, Scopus, CENTRAL to identify cohort observational studies, case controls, and randomized control trial (RCT) studies, evaluating the effect of methotrexate therapy on cognitive function disorder in RA patients. The Newcastle-Ottawa Scale (NOS Scale) was used to analyze the quality of existing observational studies and The COCHRANE was used to analyze the RCT studies which included in the journals reviewed. Results. There were 4 observational studies that met the criteria, including 2 case control studies and 2 cohort studies. Pooling was carried out in two different types of studies. The OR was 0.81 (95%CI 0.4 – 1.68) in the case control studies group, whereas the RR was 0.88 (95% CI 0 .6 – 1.3) in the cohort studies group. The heterogeneity of each type of case-control studies and cohort studies were I2 92% (p-value277% (p-value Conclusion. Methotrexate therapy has not been proven to have an effect on cognitive disorder in RA patients either as a protective factor or as a risk factor.
Obesity and methotrexate treatment failure in rheumatoid arthritis patients in Cipto Mangunkusumo Hospital, Indonesia Fauzia, Fara; Adnan Prihartono, Nurhayati; C. Adisasmita, Asri; Umi Partan, Radiyati; Djuwita Hatma, Ratna; Hidayat, Rudy
International Journal of Public Health Science (IJPHS) Vol 13, No 3: September 2024
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v13i3.24046

Abstract

Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease which mainly manifests in the joints. Methotrexate (MTX) is a widely used pharmacological treatment for RA. To date, no prior research has investigated the effect of obesity on MTX treatment outcomes among RA patients in Indonesia. This research aimed to investigate the effect of obesity on MTX monotherapy failure in RA patients. We conducted a retrospective cohort study using medical records from the Rheumatology Clinic at Cipto Mangunkusumo Hospital from March 2017 to December 2021. Descriptive and estimation analyses were performed to assess the sample characteristics based on each variable and a logistic regression analysis was conducted to evaluate the association between obesity and MTX treatment failure. Out of 72 subjects, the proportion of MTX treatment failure was 57.1% (20/35) among obese patients and 37.8% (14/37) among non-obese patients. Obese subjects exhibited a 2.11-fold increased risk of MTX treatment failure compared to non-obese patients (OR 2.11; 95% CI 0.81-5.45). The number of joints involved was found to emerge as a confounding factor in this study. Our findings suggest that RA patients with obesity potentially have an increased risk of MTX treatment failure compared to non-obese RA patients.