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Risk of higher dose methotrexate for renal impairment in patients with rheumatoid arthritis.
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- Author(s): Hayashi K;Hayashi K; Sada KE; Sada KE; Asano Y; Asano Y; Asano SH; Asano SH; Yamamura Y; Yamamura Y; Ohashi K; Ohashi K; Morishita M; Morishita M; Watanabe H; Watanabe H; Narazaki M; Narazaki M; Matsumoto Y; Matsumoto Y; Wada J; Wada J
- Source:
Scientific reports [Sci Rep] 2020 Oct 30; Vol. 10 (1), pp. 18715. Date of Electronic Publication: 2020 Oct 30.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
- Publication Information: Original Publication: London : Nature Publishing Group, copyright 2011-
- Subject Terms: Arthritis, Rheumatoid/*drug therapy ; Kidney/*drug effects ; Kidney Diseases/*drug therapy ; Methotrexate/*administration & dosage ; Methotrexate/*adverse effects; Aged ; Dose-Response Relationship, Drug ; Female ; Glomerular Filtration Rate ; Humans ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/adverse effects ; Japan ; Male ; Middle Aged ; Regression Analysis ; Retrospective Studies ; Surveys and Questionnaires
- Abstract: Renal impairment is a major concern in patients taking high-dose methotrexate (MTX) for malignancy, but it has not been fully explored in rheumatoid arthritis (RA) patients taking low-dose MTX. This study aimed to elucidate the dose-dependent effects of MTX on the renal function of patients with RA. We retrospectively reviewed 502 consecutive RA patients who were prescribed MTX for ≥ 1 year at Okayama University Hospital between 2006 and 2018. The primary outcome was the change in estimated glomerular filtration rate (eGFR) over 1 year. The association between MTX dosage (< 8, 8-12, and ≥ 12 mg/week) and the change in eGFR was evaluated using multiple linear regression analysis with adjustment for possible confounding factors including age, sex, disease duration, body weight, comorbidity, baseline eGFR, concomitant treatment, and disease activity. Mean patient age was 63 years; 394 (78%) were female. Median disease duration was 77 months, while mean MTX dosage was 8.6 mg/week. The last 1-year change of eGFR (mean ± SD) in patients treated with MTX < 8 (n = 186), 8-12 (n = 219), ≥ 12 mg/week (n = 97) decreased by 0.2 ± 7.3, 0.6 ± 8.6, and 4.5 ± 7.9 mL/min/1.73 m 2 /year, respectively (p < 0.0001). After adjustment for the confounding factors, MTX ≥ 12 mg/week was still correlated with a decrease in 1-year eGFR (beta-coefficient: - 2.5; 95% confidence interval, - 4.3 to - 0.6; p = 0.0089) in contrast to MTX 8-12 mg/week. Careful monitoring of renal function is required in patients with MTX ≥ 12 mg/week over the course of RA treatment regardless of disease duration.
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Ann Rheum Dis. 2017 Jan;76(1):96-104. (PMID: 27165179) - Accession Number: 0 (Immunosuppressive Agents)
YL5FZ2Y5U1 (Methotrexate) - Publication Date: Date Created: 20201031 Date Completed: 20210303 Latest Revision: 20210303
- Publication Date: 20231215
- Accession Number: PMC7599222
- Accession Number: 10.1038/s41598-020-75655-9
- Accession Number: 33127957
- Source:
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