TY - JOUR
T1 - Methotrexate and Cardiovascular Protection: Current Evidence and Future Directions
AU - Mangoni, Arduino
AU - Zinellu, Angelo
AU - Sotgia, Salvatore
AU - Carru, Ciriaco
AU - Erre, Gian
PY - 2017
Y1 - 2017
N2 - Patients with autoimmune rheumatic conditions, particularly rheumatoid arthritis, have an increased cardiovascular risk when compared with the general population. Methotrexate is a relatively old, yet effective, immunomodulatory drug for the management of autoimmune and chronic inflammatory disorders, such as rheumatoid arthritis, particularly in terms of symptom control, quality of life, and disease progression. Recent meta-analyses have also shown that methotrexate treatment is associated with a lower risk of cardiovascular events when compared with other disease-modifying antirheumatic drugs. This suggests that methotrexate might exert specific protective effects against atherosclerosis and thrombosis. This mini-review discusses the mechanisms associated with the increased cardiovascular risk in rheumatoid arthritis, the pharmacokinetics and pharmacodynamics of methotrexate, the available evidence on the in vitro and in vivo effects of methotrexate on modifiable cardiovascular risk factors, and suggestions for future research directions.
AB - Patients with autoimmune rheumatic conditions, particularly rheumatoid arthritis, have an increased cardiovascular risk when compared with the general population. Methotrexate is a relatively old, yet effective, immunomodulatory drug for the management of autoimmune and chronic inflammatory disorders, such as rheumatoid arthritis, particularly in terms of symptom control, quality of life, and disease progression. Recent meta-analyses have also shown that methotrexate treatment is associated with a lower risk of cardiovascular events when compared with other disease-modifying antirheumatic drugs. This suggests that methotrexate might exert specific protective effects against atherosclerosis and thrombosis. This mini-review discusses the mechanisms associated with the increased cardiovascular risk in rheumatoid arthritis, the pharmacokinetics and pharmacodynamics of methotrexate, the available evidence on the in vitro and in vivo effects of methotrexate on modifiable cardiovascular risk factors, and suggestions for future research directions.
KW - Cardiovascular disease
KW - Cardiovascular risk factors
KW - Inflammation
KW - Methotrexate
KW - Rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=85045017469&partnerID=8YFLogxK
U2 - 10.1177/1179559X17741289
DO - 10.1177/1179559X17741289
M3 - Article
VL - 9
SP - 1
EP - 12
JO - Clinical Medicine Insights: Therapeutics
JF - Clinical Medicine Insights: Therapeutics
SN - 1179-559X
ER -