Effect of methotrexate on pulmonary involvement in patients with rheumatoid arthritis

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APLAR Journal of Rheumatology

Volume 7 Issue 1 Page 24 - May 2004

doi:10.1111/j.1479-8077.2004.00056.x

ORIGINAL ARTICLE

Effect of methotrexate on pulmonary involvement in patients with rheumatoid

arthritis

Tas Gökhan1, Özoran Kürsat1, Ak Gülseren1, Bostanoglu Sevinç2, Arikan

Serpil3 and Mermerci Bedriye1

Abstract

Objective: The aim of this study is to determine the effects of methotrexate

(MTX) therapy on pulmonary involvement in patients with rheumatoid arthritis

(RA).

Method: Fifty-five non-smoking RA patients were included in the study.

Routine laboratory investigations, pulmonary function tests (PFT), high

resolution computed tomography (HRCT) and arterial blood gas analysis were

performed in all of the patients. Randomly dividing the patients into two

groups, the first group were given 7.5 mg/week MTX and the second group were

given 250 mg/day chloroquine phosphate. At the end of the sixth month all

the tests and the analysis were repeated and evaluated by using chi2 and

Student's t-test; P < 0.05 was considered statistically significant.

Results: At the beginning of the study, HRCT examination revealed 92.7%

pulmonary involvement in 55 RA patients. At the sixth month although the RA

patients in the chloroquine group did not show any difference, RA patients

in the MTX group displayed statistically significant increases in their

pulmonary involvement (P < 0.05). Patients in the MTX group also displayed

significant decreases at FEV1/FVC and significant increases at FEV1 in PFT

and O2 saturation (P < 0.05, P < 0.05 and P < 0.01, respectively). In the

chloroquine group we observed significant increases in FEV1 and vital

capacity (P < 0.05).

Conclusion: Although the MTX therapy increases the risk of pulmonary

involvement in patients with RA, it also increases the ventilation which in

turn increases the functional capacity of the patient. Considering the

beneficial effect on the radiological progression of the disease, we think

that MTX therapy should be taken into account as the first choice in the

treatment of RA.