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Pulmonary function in rheumatoid arthritis treated with low-dose methotrexate: a longitudinal study
C Beyeler1, B Jordi, N J Gerber
1Department of Rheumatology, University Hospital, Berne, Switzerland.
British Journal of Rheumatology
|May 1, 1996
Summary
Methotrexate (MTX) treatment generally does not significantly impact lung function in rheumatoid arthritis patients. Most patients maintained stable lung volumes and gas exchange over time, with minor changes attributed to aging.
Area of Science:
- Rheumatology
- Pulmonology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) can affect lung function.
- Methotrexate (MTX) is a common treatment for RA, but its pulmonary effects are debated.
- Assessing MTX's impact on lung health in RA patients is crucial.
Purpose of the Study:
- To prospectively evaluate the long-term effects of intramuscular methotrexate on pulmonary function in rheumatoid arthritis patients.
- To identify any risk factors associated with MTX-induced lung function decline.
Main Methods:
- Prospective study of 96 RA patients treated with intramuscular MTX.
- Longitudinal assessment of lung volumes (FVC, FEV1) and gas exchange (TL,CO, P(A-a),O2) over a mean of 2.9 years.
- Regression analysis used to assess individual changes over time.
Main Results:
- Forced vital capacity (FVC) remained stable; transfer factor (TL,CO) was largely unaltered.
- Slight but significant annual decreases in forced expiratory volume in 1 s (FEV1) and increases in alveolar-arterial oxygen gradients (P(A-a),O2) were observed.
- These changes were small and potentially related to aging; no significant risk factors identified.
Conclusions:
- Intramuscular methotrexate has no major adverse effect on pulmonary function in the majority of RA patients.
- No increased risk of lung function deterioration was found in patients with pre-existing pulmonary conditions.
- MTX appears to be a safe option for RA patients regarding lung health.