Effects of Methotrexate on Carotid Intima-media Thickness in Patients with Rheumatoid Arthritis

Area of Science:

• Rheumatology
• Cardiology
• Pharmacology

Background:

• Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular diseases (CVD).
• Atherosclerosis, measured by carotid intima-media thickness (CIMT), is a key indicator of CVD.
• The impact of RA and its treatments on atherosclerosis requires further investigation.

Purpose of the Study:

• To evaluate the effects of rheumatoid arthritis and antirheumatic drugs on atherosclerosis.
• To compare carotid intima-media thickness (CIMT) as a marker for cardiovascular diseases (CVD) in RA patients and healthy controls.
• To assess the influence of disease activity, CVD risk factors, and specific antirheumatic drugs on CIMT in RA.

Main Methods:

• A case-control study involving 44 female RA patients and 22 age-matched healthy females.
• Carotid intima-media thickness (CIMT) was measured using B-mode ultrasound, with the mean of both carotid arteries used.
• Statistical analysis was performed to evaluate CIMT based on drug use, disease activity, and CVD risk factors.

Main Results:

• RA patients exhibited significantly higher CIMT compared to healthy subjects (0.705 ± 0.198 mm vs. 0.611 ± 0.093 mm, P < 0.05).
• Methotrexate (MTX) treatment was associated with significantly lower CIMT in RA patients compared to those without MTX (0.644 ± 0.136 mm vs. 0.767 ± 0.233 mm, P < 0.05), even after adjusting for CVD risk factors and disease activity.
• The beneficial effect of MTX on CIMT was dose-dependent (β = -0.029, P < 0.01).

Conclusions:

• Rheumatoid arthritis is linked to increased atherosclerosis, as evidenced by elevated CIMT.
• Methotrexate demonstrates a favorable effect on reducing CIMT in RA patients, suggesting a protective role against cardiovascular complications.
• Prioritizing MTX use in RA management may not only control arthritis but also mitigate RA-related CVD risk and mortality.