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  • Methotrexate safe in...

Methotrexate safe in Dermatomyositis Patients, may not increase risk of interstitial lung disease: JAMA

Written By : Jacinthlyn Sylvia |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2024-05-22T05:30:50+05:30  |  Updated On 22 May 2024 5:31 AM IST
Methotrexate safe in Dermatomyositis Patients, may not increase risk of interstitial lung disease: JAMA
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A recent cohort study published in the Journal of American Medical Association provided reassuring findings for dermatomyositis (DM) patients regarding the safety of methotrexate (MTX) usage. DM is a condition characterized by muscle weakness and skin rash, often presents with interstitial lung disease (ILD) as a complication by affecting about 23% of DM patients in North America.

The study was conducted within the NIH-sponsored All of Us Research Program to investigate the link between MTX use and ILD development in DM patients. Despite MTX being a first-line treatment for DM, the concerns over its potential pulmonary toxicity have made clinicians to hesitate its use in this patient group.

This research analyzed data from a total of 315 DM patients, of whom 163 met the inclusion criteria. Among them, 58 patients received MTX, while the other 105 did not. The study found that 17% of MTX-exposed patients and 16% of MTX-unexposed patients developed ILD, showing no significant difference in ILD risk associated with MTX use.

The findings contrast with previous studies in populations with rheumatoid arthritis (RA) where MTX has been linked with pneumonitis and pulmonary fibrosis. In the DM group, MTX did not pose a significant risk of ILD development. Also, similar results were observed when analyzing the association between ILD and mycophenolate mofetil/mycophenolic acid (MMF/MPA) which is another commonly used medication for DM.

Rituximab use was also noted in relationship with MTX in this study cohort by possibly indicating established use of these medications together or prescribing patterns based on DM subtype. MTX was negatively associated with malignant neoplasms that suggests potential prescribing patterns or indicates its lower tumorigenicity in this context.

Despite the limitations which include reliance on electronic health records and sample size constraints, these findings offer valuable insights into the safety profile of MTX in DM patients. The outcomes suggest that MTX may not significantly increase the risk of ILD in this population by challenging the previous concerns.

Further prospective studies are imperative to validate the findings of this study and explore potential factors that could influence the observed associations. Overall, this study provides reassuring evidence regarding the use of MTX as a treatment option for DM patients by offering hope for enhanced management strategies in this condition.

Source:

Shah, J. T., Richardson, W. M., Mittal, L., Castillo, R., Mazori, D. R., Caplan, A. S., & Femia, A. N. (2024). Methotrexate Use and Risk of Interstitial Lung Disease in Dermatomyositis. In JAMA Dermatology. American Medical Association (AMA). https://doi.org/10.1001/jamadermatol.2024.0785

JAMA Dermatologymethotrexatedermatomyositis
Source : JAMA Dermatology
Jacinthlyn Sylvia
Jacinthlyn Sylvia

    Neuroscience Masters graduate

    Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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