medwireNews: Methotrexate treatment does not contribute to the increased risk for interstitial lung disease (ILD) observed among patients with rheumatoid arthritis (RA), according to data from a Danish cohort study presented at the EULAR 2020 E-congress.
The researchers analyzed data pertaining to 30,512 individuals with RA included in the Danish National Patient Register and the clinical DANBIO register for rheumatic diseases between 1997 and 2015.
Of these, 60% of patients had redeemed a prescription for methotrexate, 35% for sulphasalazine, and 6% for amiodarone or nitrofurantoin during 5 years of follow-up, while 27% had not redeemed a prescription for any of these drugs, reported presenting author René Cordtz (Aalborg University Hospital, Denmark).
Patients taking methotrexate were no more likely to develop ILD as those not taking methotrexate and the same was true for patients taking sulfasalazine prescriptions versus those who were not.
Therefore, “methotrexate treatment was not associated with an increased risk for lung disease compared to non-methotrexate treatment,” Cordtz emphasized.
He added that people with RA had a three- to fivefold elevated risk for lung disease compared with the general population regardless of methotrexate treatment.
Specifically, the standardized incidence ratio (SIR) for ILD among methotrexate-treated patients was 3.63, and was 4.12 for people who took sulphasalazine alone and 5.45 for those who took both sulphasalazine and methotrexate.
And notably, even the RA patients who did not receive methotrexate or sulphasalazine were more likely to have ILD than the general population, with an SIR of 3.38.
In conclusion, Cordtz summarized: “RA patients had an increased risk of ILD compared to the general population, which was not surprising.
“But [it is] very important that the risk was not further exacerbated in those treated with methotrexate.”
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EULAR 2020 E-Congress; 3–6 June
Ann Rheum Dis 2020; doi:10.1136/annrheumdis-2020-eular.1609