Methotrexate and rheumatoid arthritis associated interstitial, Lung disease

被引：158

作者：

Juge, Pierre-Antoine ^{[1
]}

Lee, Joyce S. ^{[2
]}

Lau, Jessica ^{[3
]}

Kawano-Dourado, Leticia ^{[4
]}

Serrano, Jorge Rojas ^{[5
]}

Sebastiani, Marco ^{[6
]}

Koduri, Gouri ^{[7
]}

Matteson, Eric ^{[8
,9
]}

Bonfiglioli, Karina ^{[10
]}

Sawamura, Marcio ^{[11
]}

Kairalla, Ronaldo ^{[4
]}

Cavagna, Lorenzo ^{[12
,13
]}

Cassione, Emanuele Bozzalla ^{[12
,13
]}

Manfredi, Andreina ^{[6
]}

Mejia, Mayra ^{[5
]}

Rodriguez-Henriquez, Pedro ^{[14
]}

Gonzalez-Perez, Montserrat I. ^{[5
]}

Falfan-Valencia, Ramces ^{[15
]}

Buendia-Roldan, Ivette ^{[16
]}

Perez-Rubio, Gloria ^{[15
]}

Ebstein, Esther ^{[1
]}

Gazal, Steven ^{[17
]}

Borie, Raphael ^{[18
,19
]}

Ottaviani, Sebastien ^{[1
]}

Kannengiesser, Caroline ^{[20
]}

Wallaert, Benoit ^{[21
]}

Uzunhan, Yurdagul ^{[22
]}

Nunes, Hilario ^{[22
]}

Valeyre, Dominique ^{[22
]}

Saidenberg-Kermanac, Nathalie ^{[23
]}

Boissier, Marie-Christophe ^{[23
]}

Wemeau-Stervinou, Lidwine ^{[21
]}

Flipo, Rene-Marc ^{[24
]}

Marchand-Adam, Sylvain ^{[25
]}

Richette, Pascal ^{[26
,27
]}

Allanore, Yannick ^{[28
,29
]}

Dromer, Claire ^{[30
]}

Truchetet, Marie-Elise ^{[31
]}

Richez, Christophe ^{[31
]}

Schaeverbeke, Thierry ^{[31
]}

Liote, Huguette ^{[32
]}

Thabut, Gabriel ^{[33
]}

Deane, Kevin D. ^{[2
]}

Solomon, Joshua J. ^{[34
]}

Doyle, Tracy ^{[35
]}

Ryu, Jay H. ^{[3
]}

Rosas, Ivan ^{[35
]}

Holers, V. Michael ^{[2
]}

Boileau, Catherine ^{[20
]}

Debray, Marie-Pierre ^{[36
]}

机构：

[1] Univ Paris, Dept Rheumatol, DMU Locomot, INSERM,UMR1152,Hop Bichat Claude Bernard,AP HP, Paris, France

[2] Univ Colorado, Dept Med, Sch Med, Aurora, CO USA

[3] Mayo Clin, Div Pulm & Crit Care Med, Coll Med Sci, Rochester, MN USA

[4] Univ Sao Paulo, Heart Inst, Pulm Div, Med Sch, Sao Paulo, Brazil

[5] Inst Nacl Enfermedades Resp, Unidad Enfermedades Intersticio Pulm & Reumatol, Mexico City, DF, Mexico

[6] Univ Modena & Reggio Emilia, Rheumatol Unit, Azienda Osped Policlin Modena, Modena, Italy

[7] Southend Univ Hosp NHSFT, Rheumatol Dept, Southend On Sea, England

[8] Mayo Clin, Div Rheumatol, Coll Med & Sci, Rochester, MN USA

[9] Mayo Clin, Dept Hlth Sci Res, Coll Med & Sci, Rochester, MN USA

[10] Univ Sao Paulo, Div Rheumatol, Med Sch, Sao Paulo, Brazil

[11] Univ Sao Paulo, Div Radiol, Med Sch, Sao Paulo, Brazil

[12] Univ Pavia, Pavia, Italy

[13] IRCCS Policlin S Matteo Fdn Pavia, Pavia, Italy

[14] Hosp Gen Dr Manuel Gea Gonzalez, Dept Reumatol, Mexico City, DF, Mexico

[15] Inst Nacl Enfermedades Resp, HLA Lab, Mexico City, DF, Mexico

[16] Inst Nacl Enfermedades Resp Ismael Cosio Villegas, Res Direct, Mexico City, DF, Mexico

[17] Harvard TH Chan Sch Publ Hlth, Dept Epidmiol, Boston, MA USA

[18] Broad Inst MIT & Harvard, Program Med & Populat Genet, Cambridge, MA USA

[19] Univ Paris, Hop Bichat Claude Bernard, AP HP,DHU APOLLO,INSERM,UMR1152, Dept Pulmonol,Ctr Reference Malad Pulm Rares, Paris, France

[20] Univ Paris, Hop Bichat Claude Bernard, AP HP, INSERM,UMR1152,Dept Genet, Paris, France

[21] FHU IMMINENT, Ctr Competence Malad Pulm Rares, Serv Pneumol & Immunoallergol, CHRU Lille, Lille, France

[22] Univ Paris 13, Hop Avicenne, AP HP,Inserm 1272, Dept Pulmonol,Ctr Reference Malad Pulm Rares, Bobigny, France

[23] Hop Avicenne, AP HP, Dept Rheumatol, Bobigny, France

[24] CHU Lille, Serv Rhumatol, Lille, France

[25] CHRU Tours, Dept Pulmonol, Tours, France

[26] Univ Paris, Hop Lariboisiere, AP HP, Serv Rhumatol,DMU Locomot, Paris, France

[27] INSERM, UMR 1132, Paris, France

[28] Univ Paris, Serv Rhumatol A, Hop Cochin, AP HP, Paris, France

[29] INSERM, UMR 8104, U1016, Paris, France

[30] Ctr Hosp Univ Bordeaux, Serv Pneumol, Bordeaux, France

[31] CHU Bordeaux, Serv Rhumatol, Bordeaux, France

[32] Hop Tenon, AP HP, Serv Pneumol, Paris, France

[33] Univ Paris, Hop Bichat, AP HP, INSERM 1152,Serv Pneumol B,DHU FIRE, Paris, France

[34] Natl Jewish Hlth, Dept Med, Denver, CO USA

[35] Brigham & Womens Hosp, Dept Med, 75 Francis St, Boston, MA 02115 USA

[36] Univ Paris, Hop Bichat Claude Bernard, AP HP, Dept Radiol,INSERM,UMR1152, Paris, France

[37] Univ Paris, CRESS, INSERM, INRA, Paris, France

[38] Hop Hotel Dieu, AP HP, Ctr Epidemiol Clin, Paris, France

来源：

EUROPEAN RESPIRATORY JOURNAL | 2021年 / 57卷 / 02期

关键词：

MODIFYING ANTIRHEUMATIC DRUGS; PULMONARY-DISEASE; AMERICAN-COLLEGE; CLASSIFICATION; PNEUMONITIS; RECOMMENDATIONS; GUIDELINES; MANAGEMENT; CRITERIA; RISK;

D O I：

10.1183/13993003.00337-2020

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

100201 [内科学];

摘要：

Question addressed by the study: Methotrexate (MTX) is a key anchor drug for rheumatoid arthritis (RA) management. Fibrotic interstitial lung disease (ILD) is a common complication of RA. Whether MTX exposure increases the risk of ILD in patients with RA is disputed. We aimed to evaluate the association of prior MTX use with development of RA-ILD. Methods: Through a case-control study design with discovery and international replication samples, we examined the association of MTX exposure with ILD in 410 patients with chronic fibrotic ILD associated with RA (RA-ILD) and 673 patients with RA without ILD. Estimates were pooled over the different samples using meta-analysis techniques. Results: Analysis of the discovery sample revealed an inverse relationship between MTX exposure and RA-ILD (adjusted OR 0.46, 95% CI 0.24 0.90; p=0.022), which was confirmed in the replication samples (pooled adjusted OR 0.39, 95% CI 0.19 -0.79; p=0.009). The combined estimate using both the derivation and validation samples revealed an adjusted OR of 0.43 (95% CI 0.26 0.69; p=0.0006). MTX ever-users were less frequent among patients with RA-ILD compared to those without II,D, irrespective of chest high-resolution computed tomography pattern. In patients with RA-ILD, ILD detection was significantly delayed in MTX ever-users compared to never-users (11.4 +/- 10.4 years and 4.0 +/- 7.4 years, respectively; p<0.001). Answer to the question: Our results suggest that MTX use is not associated with an increased risk of RA-ILD in patients with RA, and that ILD was detected later in MTX-treated patients.

引用

页数：9

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