Review: Methotrexate does not increase risk for lung disease in psoriasis, psoriatic arthritis, or IBD

Research output: Contribution to journalComment/debate

Abstract

Question
In patients with psoriasis, psoriatic arthritis, or inflammatory bowel disease (IBD), does methotrexate increase risk for lung disease?

Review scope
Included studies compared methotrexate with placebo or another active agent in adults with psoriasis, psoriatic arthritis, or IBD, and reported respiratory side effects.

Review methods
MEDLINE, EMBASE/Excerpta Medica, and Cochrane Central Register of Controlled Trials (Jan 2014); and reference lists were searched for double-blind, randomized, controlled trials (RCTs) that had ≥ 50 patients, duration ≥ 12 weeks, and were published in English. 7 RCTs (n = {1630}*, mean age 33 to 49 y, 50% to 70% men), with 76 to 478 patients, met the selection criteria. Study durations were 16 to 52 weeks. The control group received placebo in 5 trials, briakinumab in 1 trial, and adalimumab/placebo in 1 trial. 4 RCTs had adequate randomization, and 4 had adequate allocation concealment.

Main results
Meta-analysis showed that methotrexate did not differ from control for overall adverse respiratory events, infectious adverse respiratory events, or noninfectious adverse respiratory events (Table). 1 patient in the methotrexate group had pneumonitis; no pulmonary deaths occurred in either group.

Conclusion
In patients with psoriasis, psoriatic arthritis, or inflammatory bowel disease, methotrexate does not increase risk for lung disease.
Original languageEnglish
Pages (from-to)JC7-JC7
Number of pages1
JournalAnnals of Internal Medicine
Volume163
Issue number2
DOIs
Publication statusPublished - 21 Jul 2015
Externally publishedYes

Keywords

  • Interstitial lung disease
  • pneumontis
  • Crohn's disease

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