A fourteen-year-old girl who became the first child in Arizona to be denied treatment for a debilitating rheumatoid arthritis and osteoporosis disease that she has suffered from for years. The girl was refused her refill prescription by Walgreen, and the company cited the drug methotrexate in the State’s anti-abortion bill, which helps provide comfort from her pain. The State of Arizona has banned methotrexate, when taken with misoprostol can be used to terminate a pregnancy.
The Arthritis Foundation writes on the crucial role the drug plays in managing pain and swelling: for lupus and arthritis sufferers.
Methotrexate is one of the mainstays of treatment for inflammatory forms of arthritis. It not only reduces pain and swelling, but it can actually slow joint damage and disease progression over time. That’s why methotrexate is known as a disease-modifying antirheumatic drug (DMARD). Many rheumatologists use methotrexate as first-line therapy for patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and juvenile idiopathic arthritis (JIA).
Methotrexate isn’t new – it’s been part of RA treatment for more than three decades. Researchers first developed this drug in the 1940s as a cancer treatment. Then in 1985, scientists discovered that it relieved pain, swelling and other symptoms in people with RA. Three years later, methotrexate won FDA approval for treating RA, and it soon became the treatment of choice for people with this condition and other forms of inflammatory arthritis as well.
Abortion restrictions following the fall of Roe v. Wade have introduced some unexpected and harmful challenges for people with autoimmune diseases: Some patients have reported being unable to obtain the drugs necessary for treatment.
Methotrexate—a drug widely used to treat rheumatoid arthritis and cancer, among other chronic diseases—is at the center of this issue. The reason? Because in addition to treating autoimmune diseases, methotrexate can also be used to terminate a pregnancy.
"Unfortunately, arthritis patients who rely on methotrexate are reporting difficulty accessing it," the Arthritis Foundation said in a recent statement. "At least one state—Texas—allows pharmacists to refuse to fill prescriptions for misoprostol and methotrexate, which together can be used for medical abortions. Already there are reports that people in Texas who miscarry or take methotrexate for arthritis are having trouble getting their prescriptions filled."
And Texas isn't the only state with this issue; patients in several states—especially those that have laws or trigger laws intended to criminalize abortion—have reported difficulty accessing their medication, Alisa Vidulich, MPH, policy director at the Arthritis Foundation, an organization that works to advance research, do advocacy, and provide disease management support, told Health.
Tucson KOLD reports: (Interview with the young woman’s mother; video is at this link).
14 year old Emma Thompson has debilitating rheumatoid arthritis and osteoporosis which has kept her in and out of the hospital for most of her life. She relies on methotrexate to help tame the effects of the disease.
But methotrexate can also be used to end ectopic pregnancies, to induce an abortion and that’s where the problem arises.
“As a mother who has had to deal with my child being very ill most of her life, I was scared, I was really worried,” said her mother Kaitlin Preble. “I was shaking. I was in tears. I didn’t know what to do.”
The young girl’s physician, Dr. Deborah Jane Power said “this was the first pediatric patient that had been denied her medication.”
She admits she was angry which spilled over into a Twitter post where she said “welcome to Arizona, she was denied because she’s female” and she said she was “livid.”
Lehar noted that any patient denied this medication is at serious risk of dangerous health consequences.
According to her doctor, the Arizona girl had so much relief from the medication she attends school.
“This child’s care has taken a lot of work to get her to a place her pain is totally manageable, she can attend school in person,” said Dr. Power.
Which is echoed by her mother.
“It’s her first year and she’s in high school and it feels like a dream,” Preble said. “She’s not in a wheelchair, she has a social life and friends for the first time and a life all young people should have.”
Which is why there was so much anxiety for the 24 hours between being denied until finally getting the prescription approved.
“I was scared, I was really scared,” Preble said. “I’m like if they deny this then we’ll have to find a different medication and we don’t know if it’s going to work.”