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Related Experiment Videos

The effect of low dose methotrexate on bone density.

A B Cranney1, R J McKendry, G A Wells

  • 1Division of Rheumatology, Ottawa Hospital, Ontario, Canada.

The Journal of Rheumatology
|November 16, 2001
PubMed
Summary

Low-dose methotrexate (MTX) does not negatively impact bone density in patients with rheumatoid arthritis or psoriatic arthritis. This study found no significant bone loss associated with long-term MTX use in these inflammatory conditions.

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Area of Science:

  • Rheumatology
  • Osteoporosis Research
  • Pharmacology

Background:

  • High-dose methotrexate (MTX) is associated with bone loss in cancer patients.
  • The effect of long-term, low-dose MTX on bone density in inflammatory arthritis is not well-established.

Purpose of the Study:

  • To investigate the association between low-dose MTX and bone mineral density (BMD) in patients with rheumatoid arthritis (RA) and psoriasis/psoriatic arthritis (Ps/PsA).

Main Methods:

  • Prospective study comparing 30 RA and 30 Ps/PsA patients on MTX with control groups (30 RA, 27 Ps/PsA) not on MTX.
  • Bone mineral density (BMD) measured at the radius, lumbar spine, trochanter, and femoral neck using dual-energy x-ray absorptiometry.
  • Statistical analysis included Student t tests and analysis of covariance to assess differences and control for confounders.

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Main Results:

  • No significant differences in BMD (Z scores) at the radius, femoral neck, or trochanter between MTX-treated groups and controls.
  • The RA MTX group showed higher absolute BMD at the lumbar spine (L2-L4) compared to controls.
  • Analysis of covariance indicated no effect of MTX treatment group on bone density after adjusting for confounders.

Conclusions:

  • Low-dose methotrexate (MTX) does not appear to negatively affect bone density at cortical or trabecular sites in patients with RA or Ps/PsA.
  • Findings suggest MTX is safe for bone health in the context of long-term inflammatory arthritis treatment.