No Risk of Interstitial Lung Disease with Methotrexate Use Save
JAMA reports a cohort study that investigated the association between methotrexate (MTX) use and Interstitial lung disease (ILD) in patients with dermatomyositis (DM).
ILD is a complication of dermatomyositis, in up to 23% of DM patients in North America. MTX is known to rarely cause pneumonitis and less commonly pulmonary fibrosis in 0.3% to 11.6% of rheumatoid arthritis patients.
The study included 315 DM patients starting immunomodulating treatment (IMT) after first DM diagnosis. A minority (36%) received MTX were compared to those that did not (64%). Both groups were clinically similar but MTX-exposed patients were less likely to have a DM-related malignant neoplasm and more likely to receive rituximab. The frequency of subsequent ILD was 17% in MTX-exposed vs 16% in MTX-unexposed. Thus, there were no significant differences in ILD risk with MTX exposure (HR 0.79; 95% CI, 0.35-1.78; P = .56).
They found similar results with MMF, known to stabilize lung function in DM but with unknown associations with ILD prevention.
These data refute the concern that MTX may induce ILD.
ADD THE FIRST COMMENT
Disclosures
The author has no conflicts of interest to disclose related to this subject
If you are a health practitioner, you may Login/Register to comment.
Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.