Introduction:
The study aimed to assess the beliefs and fears of Moroccan patients with rheumatoid arthritis (RA) regarding methotrexate (MTX) and to identify factors associated with the total score on the Beliefs about Medicines Questionnaire-Specific (BMQ).

Material and methods:
A single-center cross-sectional study was conducted in patients being treated for RA with MTX. Beliefs about treatment were assessed using the BMQ. Specific fears related to MTX were collected using a structured questionnaire developed for the study. Factors associated with the total BMQ score were explored using univariate and then multivariate linear regression.

Results:
One hundred and two patients were included (age: 53.1 ±12.5 years; 90.2% women). The mean BMQ-Concerns score was 15.9 ±6.37. The main concerns were related to potential long-term adverse effects (58.8%), particularly gastrointestinal (65.7%) and hepatic (62.7%) toxicity. A moderate or high level of fear was reported by 53.9% of patients. The mean BMQ-Necessity score was 15.0 ±5.04; 55% felt that their current health depended on MTX, and 51% perceived an overall benefit from the treatment. The median BMQ total score was 1 (from –3 to 4). In multivariate analysis, longer disease duration (β = –0.12; 95% CI: –0.23 to –0.02) and use of the internet as a source of information (β = –2.66; 95% CI: –5.06 to –0.27) were independently associated with the total score.

Conclusions:
Moroccan patients with RA generally consider MTX to be necessary but express significant concerns about its toxicity. Disease duration and use of the internet significantly influence these perceptions, highlighting the need for therapeutic education interventions and reliable digital information sources.