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Association of higher methotrexate dose with lymphoproliferative disease onset in rheumatoid arthritis patients

Tomohiro Kameda1, Hiroaki Dobashi, Nobuyuki Miyatake

  • 1Kagawa University, Kagawa, Japan.

Arthritis Care & Research
|February 12, 2014
PubMed
Abstract

Insights

Methotrexate (MTX) is an independent risk factor for lymphoproliferative disease (LPD) in rheumatoid arthritis (RA) patients. Higher MTX doses are associated with increased LPD risk in RA patients.

Area of Science:

  • Rheumatology
  • Oncology
  • Pharmacology

Background:

  • Methotrexate (MTX) is a primary treatment for rheumatoid arthritis (RA).
  • MTX-associated lymphoproliferative disease (MTX-LPD) is a rare but serious complication in RA patients.
  • The independent risk of MTX for LPD in RA patients remains unclear.

Purpose of the Study:

  • To investigate the clinical characteristics of MTX-LPD in Japanese RA patients.
  • To identify independent risk factors for MTX-LPD development.

Main Methods:

  • A nested case-control study involving 5,753 RA patients in Kagawa, Japan.
  • Comparison of patients who developed LPD (MTX-LPD group) versus those who did not (MTX non-LPD group).
  • Multivariate analysis to determine independent risk factors for MTX-LPD.

Main Results:

  • The study identified 28 patients in the MTX-LPD group and 125 in the MTX non-LPD group.
  • Multivariate analysis revealed that the mean MTX dose was a significant risk factor for MTX-LPD.
  • Higher MTX dosage was associated with an increased risk of LPD onset in RA patients.

Conclusions:

  • Methotrexate (MTX) is confirmed as an independent risk factor for LPD onset in Japanese RA patients.
  • Higher MTX doses increase the risk of developing LPD in RA patients.

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