REVIEW - The effect of MTX on cardiovascular disease in patients with RA

[Guest guest]

The Effect of Methotrexate on Cardiovascular Disease in Patients with

Rheumatoid Arthritis: A Systematic Literature Review

L. Westlake; andra N. Colebatch; Janis Baird; Kiely;

Mark Quinn; Ernest Choy; J. K. Ostor; J.

Medscape

Posted 17 Feb 2010; Rheumatology. 2010;49(2):295-307.

Abstract

Objectives. Patients with RA have an increased prevalence of

cardiovascular disease (CVD). This is due to traditional risk factors

and the effects of chronic inflammation. MTX is the first-choice DMARD

in RA. We performed a systematic literature review to determine

whether MTX affects the risk of CVD in patients with RA.

Methods. We searched Medline, Embase, Cochrane database, database of

abstracts of reviews of effects, health technology assessment and

Science Citation Index from 1980 to 2008. Conference proceedings

(British Society of Rheumatology, ACR and EULAR) were searched from

2005 to 2008. Papers were included if they assessed the relationship

between MTX use and CVD in patients with RA. Two reviewers

independently assessed each title and abstract for relevance and

quality.

Results. A total of 2420 abstracts were identified, of which 18

fulfilled the inclusion criteria. Two studies assessed the

relationship between MTX use and CVD mortality, one demonstrated a

significant reduction in CVD mortality and the second a trend towards

reduction. Five studies considered all-cause CVD morbidity. Four

demonstrated a significant reduction in CVD morbidity and the fifth a

trend towards reduction. MTX use in the year prior to the development

of RA decreased the risk of CVD for 3–4 years. Four studies considered

myocardial infarction, one demonstrated a decreased risk and three a

trend towards decreased risk with MTX use.

Conclusion. The current evidence suggests that MTX use is associated

with a reduced risk of CVD events in patients with RA. This suggests

that reducing the inflammation in RA using MTX not only improves

disease-specific outcomes but may also reduce collateral damage such

as atherosclerosis.

******************************************

Read the full article here:

http://www.medscape.com/viewarticle/716450

Not an MD