Abstract
Background. Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. First-line therapy for JIA includes methotrexate (MTX); however, it can cause adverse events, which necessitates early diagnosis of MTX intolerance. The Methotrexate Intolerance Severity Score (MISS) is one of diagnostic instruments that can be used for this purpose. Objective. To validate, customize, and implement the MISS questionnaire into clinical practice. Patients and methods. This cross-sectional study was conducted between January and May 2022 and included 100 JIA patients (32 boys and 68 girls) aged ≤17 years receiving MTX. We validated the MISS questionnaire to evaluate possible adverse events associated with MTX. We performed linguistic and cultural customization of the MISS questionnaire. To assess the reliability of the questionnaire, we calculated the Cronbach's alpha coefficient. Results. Cronbach's alpha coefficient showed that MISS is a reliable tool to detect MTX intolerance. We found that more than a quarter of patients had MTX intolerance with nausea being the most common complaint among the participants. Conclusion. Despite high MTX efficacy in clinical practice, patients often demonstrated poor treatment adherence due to MTXrelated adverse events. It is important to continue the implementation of the Russian version of MISS to ensure early detection of adverse events and timely initiation of adequate treatment. Key words: children, juvenile idiopathic arthritis, methotrexate, Methotrexate Intolerance Severity Score, drug intolerance
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