Duration of effect in treatment of methotrexate intolerance in juvenile idiopathic arthritis using eye movement desensitization and reprocessing (EMDR) can be improved by bi-lateral alternating stimulation tactile (BLAST) wristbands

Description

Background
Methotrexate (MTX) intolerance in juvenile idiopathic arthritis (JIA) frequently leads todiscontinuation due to anticipatory and associative gastrointestinal symptoms. Eye Movement Desensitization and Reprocessing (EMDR) has successfully been used in MTX intolerance, with lastingeffects but frequently diminishing effi cacy over time. BLAST (bi-lateral alternating stimulation tactile)wristbands utilize a similar process to EMDR. The aim of this study was to determine if utilization ofBLAST wristbands could improve and prolong the effect of EMDR on patients with MTX intolerance.

Methods
Consecutive patients admitted to the German Center for Pediatric and AdolescentRheumatology with JIA and signs of MTX intolerance from October 2016 until March 2024 were includedin this study. Treatment was performed using an adapted 8 phase EMDR protocol implementing BASTwristbands. Initial patients were treated with EMDR, subsequent patients additionally with BLASTwristbands. Health-related quality of live was determined using the PedsQL. Measurements of MISS and PedsQLwere taken at 4 time points: directly before and after (MISS only) treatment, as well as 4 and 12 monthsafter treatment. Changes in MISS and PedsQL were compared using descriptive statistics and repeatedmeasures ANOVA.

Results
87 patients with MTX intolerance were included, 53 in group 1 without BLAST wristbands and 34in group 2 which were concurrently treated with BLAST wristbands. All patients reported marked improvement of MTX intolerance symptoms (mean MISS score group 1:15.0 ± 5.5 before treatment, 1.3 ± 1.5 after treatment, group 2: 16.8 ± 5.6 and 2.5 ± 2.5, respectively). After 4 and 12 months, MISS in group 1 was 8.1 ± 7.1 and 8.7 ± 8.4, and in group 2: 7.1 ± 6.3 and 6.5 ±5.7. A repeated measures ANOVA showed a signifi cant difference between the MISS results over time(F(3,114) = 64.6, p < 0.001), and also demonstrated a signifi cant difference of the PedsQL results between the two groups over time (F(2,64) = 8.9, p < 0.001).

Conclusion
Treatment with Eye Movement Desensitization and Reprocessing (EMDR) presents aneffective treatment of MTX intolerance, and further signifi cant improvement can be achieved usingBLAST wristbands. Introduction Juvenile

Format

Journal

Language

English

Author(s)

Lea Höfel
Bruno Eppler
Johannes-Peter Haas
Boris Hugle

Collection

Citation

“Duration of effect in treatment of methotrexate intolerance in juvenile idiopathic arthritis using eye movement desensitization and reprocessing (EMDR) can be improved by bi-lateral alternating stimulation tactile (BLAST) wristbands,” Francine Shapiro Library, accessed July 15, 2024, https://francineshapirolibrary.omeka.net/items/show/29252.

Output Formats