REVIEW - Pulmonary effects of low-dose MTX therapy

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Pulmonary Effects of Low-Dose Methotrexate Therapy.

Interstitial, Inflammatory, and Occupational Lung Disease

Clinical Pulmonary Medicine. 11(5):307-317, September 2004.

Dawson, K. MD *; Clewes, R. MRCPI *; Hendry, MD

Abstract:

Low-dose, weekly methotrexate (MTX) is increasingly being used by

respiratory physicians and is established therapy for rheumatoid arthritis

and psoriasis. MTX appears to have a small corticosteroid sparing effect in

asthma and sarcoidosis. While MTX has been evaluated in the treatment of

Wegener's granulomatosis, studies have excluded patients with severe

respiratory disease, and comparisons with current immunosuppressive regimens

have not been reported. The pulmonary complications of MTX are MTX

pneumonitis (MTX-P), opportunistic infections, and possibly drug-induced

asthma. MTX-P occurs in approximately 5% of patients commencing MTX, occurs

in the first 32 weeks of therapy in 50% of patients, and can be fatal in 17%

of cases. We do not advocate reintroduction of MTX after an episode of

MTX-P.

© 2004 Lippincott & Wilkins, Inc.

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