Methotrexate use linked to reduced mortality in RA

Mary Chester M. Wasko, M.D., from the West Penn Allegheny Health System in Pittsburgh, and colleagues assessed the association between methotrexate use and mortality in a cohort of 5,626 patients with RA, studied prospectively for 25 years, after controlling for individual propensity scores for methotrexate use.

The researchers found that 666 patients (12 percent) died during follow-up. There was a reduced risk of death with methotrexate use (adjusted hazard ratio, 0.30; 95 percent confidence interval, 0.09 to 1.03). The protective association between methotrexate use and mortality was not accounted for by selective methotrexate cessation immediately before death. The lower mortality risk was only associated with methotrexate use longer than one year, with no stronger associations linked to longer durations of use.

"These findings have implications for the use of MTX in the treatment of RA," the authors write. "For patients in whom MTX monotherapy does not achieve complete control, add-on therapy may be more appropriate than switching to other medications, as MTX may still carry a survival benefit."

One author disclosed financial ties to the pharmaceutical industry.

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Journal reference: Arthritis & Rheumatism

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