Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow A corrigendum has been published
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (25)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Dawson, J. K.
Right arrow Articles by Lynch, M. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dawson, J. K.
Right arrow Articles by Lynch, M. P.
Related Collections
Right arrow Diagnostics and Imaging Procedures
Right arrow Rheumatoid Arthritis
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Rheumatology 2002; 41: 262-267
© 2002 British Society for Rheumatology

Original Papers

Investigation of the chronic pulmonary effects of low-dose oral methotrexate in patients with rheumatoid arthritis: a prospective study incorporating HRCT scanning and pulmonary function tests

J. K. Dawson, D. R. Graham1, J. Desmond2, H. E. Fewins3 and M. P. Lynch*

Departments of Rheumatology,
1 Cardiorespiratory Medicine and
2 Radiology, St Helens and Knowsley Trust Hospitals, Merseyside and
3 Department of Radiology, Cardiothoracic Centre, Merseyside, UK

Objective. Methotrexate has a well-recognized side-effect of acute hypersensitivity pneumonitis. There is concern about whether chronic pulmonary toxicity can occur with methotrexate treatment. Our objective was to compare chest high-resolution computed tomography (HRCT) findings and serial pulmonary function tests in rheumatoid arthritis (RA) patients on methotrexate with findings for a control group of patients with RA who were not being treated with methotrexate.

Methods. Study patients had an initial chest radiograph, full pulmonary function tests and chest HRCT. Pulmonary function tests were then performed regularly over a 2-yr period.

Results. Fifty-five RA patients on methotrexate and 73 control patients with RA were enrolled for the study. Mean dose of methotrexate was 10.7 mg/week (S.D. 2.5 mg/week) and mean duration of treatment at entry into the study was 30 (20) months. Twenty per cent of patients with RA treated with methotrexate had pulmonary fibrosis (PF) on initial HRCT compared with 23% in the control group. When the patients with and without PF were compared, there was no statistical difference in the duration (mean difference -4.18 months, P=0.237) or dose (mean difference -0.8 mg/week P=0.52) of methotrexate therapy. Mean changes after 2 yr in forced expiratory volume, forced vital capacity, diffusion capacity for carbon monoxide and residual volumes were not different in the methotrexate group compared with the control group.

Conclusion. There is no evidence to suggest clinically, from HRCT assessment or serial pulmonary function tests, that low-dose methotrexate is associated with chronic interstitial lung disease.

KEY WORDS: Methotrexate, Interstitial lung disease, Rheumatoid arthritis, Pulmonary fibrosis.

Correspondence to: J. K. Dawson, Department of Rheumatology, St Helens Hospital, Marshalls Cross Road, St Helens, Merseyside WA9 3DA, UK.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Rheumatology (Oxford)Home page
V. Saravanan and C. A. Kelly
Reducing the risk of methotrexate pneumonitis in rheumatoid arthritis
Rheumatology, February 1, 2004; 43(2): 143 - 147.
[Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
G. Provenzano
Chronic pulmonary toxicity of methotrexate and rheumatoid arthritis
Rheumatology, June 1, 2003; 42(6): 802 - 803.
[Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
J. K. Dawson and M. P. Lynch
Reply
Rheumatology, June 1, 2003; 42(6): 803 - 804.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.