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Methotrexate use and risk of lung disease in psoriasis, psoriatic arthritis, and inflammatory bowel disease: systematic literature review and meta-analysis of randomised controlled trials.

Conway R, Low C, Coughlan RJ, O'Donnell MJ, Carey JJ - BMJ (2015)

Bottom Line: We compared relative risk differences using the Mantel-Haenszel random effects method to assess total respiratory adverse events, infectious respiratory adverse events, non-infectious respiratory adverse events, interstitial lung disease, and death.Findings suggested that there was no increased risk of lung disease in methotrexate treated patients with non-malignant inflammatory diseases.Given the limitations of the study, however, we cannot exclude a small but clinically important risk.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology, Galway University Hospitals, Galway, Republic of Ireland National University of Ireland Galway, Galway, Republic of Ireland drrichardconway@gmail.com.

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Fig 2 Forest plot of relative risk for total adverse respiratory events for methotrexate compared with comparator agents
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fig2: Fig 2 Forest plot of relative risk for total adverse respiratory events for methotrexate compared with comparator agents

Mentions: Overall, 504 respiratory adverse events were documented (table 2). Although the I2 index was low (0%), the type and number of respiratory adverse events reported varied considerably between the studies so we chose a random effects model for our analyses. Overall, methotrexate was not associated with an increased risk of total adverse respiratory events compared with comparator agents (relative risk 1.03, 95% confidence interval 0.90 to 1.17, I2=0%, fig 2). In addition we found no increased risk in infectious respiratory events (1.02, 0.88 to 1.19, I2=0%) nor non-infectious respiratory adverse events (1.07, 0.58 to 1.96, I2=0%) (see supplementary figures 1 and 2). No pulmonary deaths occurred. A single case of pneumonitis was reported in a patient treated with methotrexate in one study, but no definitive diagnostic features or additional information were reported.20


Methotrexate use and risk of lung disease in psoriasis, psoriatic arthritis, and inflammatory bowel disease: systematic literature review and meta-analysis of randomised controlled trials.

Conway R, Low C, Coughlan RJ, O'Donnell MJ, Carey JJ - BMJ (2015)

Fig 2 Forest plot of relative risk for total adverse respiratory events for methotrexate compared with comparator agents
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4358852&req=5

fig2: Fig 2 Forest plot of relative risk for total adverse respiratory events for methotrexate compared with comparator agents
Mentions: Overall, 504 respiratory adverse events were documented (table 2). Although the I2 index was low (0%), the type and number of respiratory adverse events reported varied considerably between the studies so we chose a random effects model for our analyses. Overall, methotrexate was not associated with an increased risk of total adverse respiratory events compared with comparator agents (relative risk 1.03, 95% confidence interval 0.90 to 1.17, I2=0%, fig 2). In addition we found no increased risk in infectious respiratory events (1.02, 0.88 to 1.19, I2=0%) nor non-infectious respiratory adverse events (1.07, 0.58 to 1.96, I2=0%) (see supplementary figures 1 and 2). No pulmonary deaths occurred. A single case of pneumonitis was reported in a patient treated with methotrexate in one study, but no definitive diagnostic features or additional information were reported.20

Bottom Line: We compared relative risk differences using the Mantel-Haenszel random effects method to assess total respiratory adverse events, infectious respiratory adverse events, non-infectious respiratory adverse events, interstitial lung disease, and death.Findings suggested that there was no increased risk of lung disease in methotrexate treated patients with non-malignant inflammatory diseases.Given the limitations of the study, however, we cannot exclude a small but clinically important risk.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology, Galway University Hospitals, Galway, Republic of Ireland National University of Ireland Galway, Galway, Republic of Ireland drrichardconway@gmail.com.

Show MeSH
Related in: MedlinePlus