Friday, 19 Jul 2019

You are here

Methotrexate Use Not Linked to Interstitial Lung Disease in RA

People with rheumatoid arthritis have a significant risk of developing interstitial lung disease (RA-ILD), yet there is often a question as to whether methotrexate (MTX) exposure can cause or worsen ILD.  A controlled cohort study suggests that MTX use is not associated with an increased risk of RA-ILD and instead, there is evidence suggesting MTX use may delay the onset of ILD.

RA patients from two early RA inception cohort studies ERAS, ERAN) in the UK, Wales and Ireland were assessed for ILD and their therapies. They found 92 eligible ILD cases; 39 occurred in 1578 (2.5%) MTX exposed and 53 in 1114 (4.8%) non-MTX exposed cases.

The primary analysis showed MTX exposure was not associated with incident RA-ILD (OR 0.85, 95% CI 0.49 to 1.49, p=0.578) and there was a non-significant trend for a delayed ILD diagnosis (OR 0.54, 95% CI 0.28 to 1.06, p=0.072).

Instead, MTX exposure was associated with a significantly reduced risk of incident RA-ILD (OR 0.48, 95% CI 0.3 to 0.79, p=0.004).

Other independent risk factors included baseline (higher) age of RA onset, ever smoking, male gender, rheumatoid nodules and longer time from first RA symptom to first outpatient visit.

 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

EHR-Related Adverse Events Usually Involve Medications

Concerns about the unintended risks inherent in electronic health records (EHR) by analysis of EHR–related harms identified from large database of malpractice suits and claims; they found that EHR related adverse events exist, and may be associated with an severe harms and uncommonly, death.

FDA Adds Boxed Warning to Sleep Drugs

The Food and Drug Administration (FDA) added a Boxed Warning to several sleep medications (e.g., eszopiclone, zaleplon, and zolpidem), warning rare but serious injuries may occur as a result of abnormal sleep behaviors (sleepwalking, sleep driving, and engaging in other activities while not fully awake) when taking sleep medications. These complex sleep behaviors have also resulted in deaths.

Update on Vaccines in Autoimmune Patients

Although both the disease and the treatment for it in rheumatology patients may work at cross-purposes with immunizations, only a very few vaccines are absolutely contraindicated in this population, an infectious disease specialist told rheumatologists here.

RheumNowLive On Demand: Infection Prevention and Management with Newer Agents - Jack Cush, MD

A clip from RheumNow Live On Demand. You can access the full library of content from the meeting.

Acute Problems Associated With Cannabis Use

An observational study published in Annals of Internal Medicine finds that emergency department (ED) visits attributable to inhaled cannabis are more frequent than those attributable to edible cannabis, although the latter is associated with more acute psychiatric visits and more ED visits than expected.