The effect of gender on methotrexate prescription attitudes in Italian rheumatoid arthritis patients: the MARI study.

OBJECTIVES: The MARI study investigated the prescription patterns of methotrexate (MTX) in patients presenting with rheumatoid arthritis (RA) in Italy. The primary aims of this cross-sectional analysis from the MARI study were to investigate the effect of gender on the prescription patterns and safety of MTX therapy. METHODS: The study enrolled 1336 patients with RA. Retrospective data included patients' clinical history, previous treatment with MTX and other DMARDs, and MTX modifications in the previous 12-month period. Cross-sectional data included information about current treatment with MTX (dose and route of administration, and adverse events), concomitant medications, disease activity, and modifications of MTX treatment at study entry. The prescription patterns of MTX, rates and causes of MTX modifications were analysed according to gender. RESULTS: There were no significant differences related to gender in the prescription patterns of MTX, either at 6 months after starting MTX or at the time of study entry. In the 12 months prior to study entry, women (4%) were more likely to undergo MTX modifications (dose or route of administration) compared to men (2%, p=0.032), due to subjective intolerance, but this difference was no longer significant after controlling for confounders. At study entry, a higher proportion of women (27%) reported tolerability issues (nausea and weakness) related to MTX compared to men (14%, p=0.001). Although a similar percentage of males and females changed dose or route of administration of MTX at the time of study entry, the reasons for such modifications were dissimilar between genders. Particularly, a higher proportion of women underwent MTX modification due to intolerance (women 6% vs. men 1%, p=0.002). CONCLUSIONS: In Italy, prescription patterns of MTX do not differ between genders. However, women seem to be at higher risk of adverse events leading to MTX modifications.

Associations between low levels of serum uric acid and cardiometabolic parameters.

INTRODUCTION: Elevated serum uric acid (SUA) levels are associated with increased cardiovascular risk. OBJECTIVE: To evaluate the association between SUA levels and cardiometabolic parameters. MATERIALS AND METHODS: SUA levels and metabolic parameters were evaluated in 139 subjects, divided into low (<5 mg/dl) and high SUA group (≥5 mg/dl). RESULTS: In low SUA group, SUA levels directly correlated with creatinine, body mass index, waist circumference, blood pressure, glucose and insulin levels, triglyceride and C-reactive protein levels. In high SUA group, SUA levels directly correlated with body weight, triglyceride, C-reactive protein, and inversely correlated with HDL-cholesterol concentrations. DISCUSSION AND CONCLUSIONS: High SUA levels were linked with several cardiometabolic parameters, and low SUA levels were linearly correlated with recognized cardiovascular risk factors. Therefore, increasing SUA levels - even at low concentration - could be associated with higher cardiovascular risk. Thus the range of normality for SUA level should be further analysed.

Serum uric acid levels and metabolic syndrome.

OBJECTIVE: To investigate the relationship among serum uric acid levels and metabolic syndrome. MATERIALS AND METHODS: Anthropometric parameters, serum uric acid and metabolic parameters were evaluated in 139 subjects. RESULTS: Serum uric acid levels were significantly higher in subjects with than without metabolic syndrome (p < 0.0001), and raised gradually with the increasing number of metabolic syndrome components (p for trend < 0.0001). Serum uric acid significantly correlated with various anthropometric and serum metabolic parameters. DISCUSSION AND CONCLUSIONS: Serum uric acid levels were higher in individuals with rather than without metabolic syndrome and raised gradually as the number of metabolic syndrome components increased. The relationship between serum uric acid levels and various metabolic parameters suggests that uric acid might be considered as a component of metabolic syndrome. CONTEXT: Hyperuricemia is a common finding in patients with the metabolic syndrome. Recent studies indicated that hyperuricemia may be also a predictor of metabolic syndrome development.