Cargando…

Higher Risk of Cardiovascular Diseases in Rheumatoid Arthritis Patients Without Methotrexate Treatment

Cardiovascular diseases (CVDs) lead to higher morbidity and mortality in rheumatoid arthritis; thus, we aimed to determine whether patients who had discontinued methotrexate treatment before the study enrollment (group MTX 0) were at a higher risk of CVD than patients treated with methotrexate at th...

Descripción completa

Detalles Bibliográficos
Autores principales: Hloch, Karel, Doseděl, Martin, Duintjer Tebbens, Jurjen, Žaloudková, Lenka, Medková, Helena, Vlček, Jiří, Soukup, Tomáš, Pávek, Petr
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8602828/
https://www.ncbi.nlm.nih.gov/pubmed/34803668
http://dx.doi.org/10.3389/fphar.2021.703279
_version_ 1784601643086512128
author Hloch, Karel
Doseděl, Martin
Duintjer Tebbens, Jurjen
Žaloudková, Lenka
Medková, Helena
Vlček, Jiří
Soukup, Tomáš
Pávek, Petr
author_facet Hloch, Karel
Doseděl, Martin
Duintjer Tebbens, Jurjen
Žaloudková, Lenka
Medková, Helena
Vlček, Jiří
Soukup, Tomáš
Pávek, Petr
author_sort Hloch, Karel
collection PubMed
description Cardiovascular diseases (CVDs) lead to higher morbidity and mortality in rheumatoid arthritis; thus, we aimed to determine whether patients who had discontinued methotrexate treatment before the study enrollment (group MTX 0) were at a higher risk of CVD than patients treated with methotrexate at the time of the data collection (group MTX 1). A retrospective, prospective, observational, cross-sectional study was conducted. A total of 125 patients were enrolled in the study. Patients from the MTX 0 group (n = 35) were not treated with methotrexate for 7.54 (SD ± 4.21) years in average. Medical documentation as well as information taken in patient examinations during regular rheumatologist visits was used to obtain the required data. The composite of any CVD occurred less frequently in patients in the MTX 1 group than in the MTX 0 group (18.8 vs. 40.0%, OR 0.35, 95% CI, 0.15 to 0.83; p = 0.017) with a non-significant trend after adjustment for other treatments, which differed between study groups at the baseline (p = 0.054). Significant difference was found for the reduction of myocardial infarction in the MTX 1 group compared to the MTX 0 group (3.5 vs. 14.3%, OR 0.22, 95% CI, 0.05 to 0.97; p = 0.046). There were 4 deaths (4.7%) in the MTX 1 group as compared with 7 (20.0%) in the MTX 0 group (OR 0.20, 95% CI, 0.05 to 0.73; p = 0.015). Our results demonstrate that patients who discontinued methotrexate treatment are at a significantly higher risk of CVD and all-cause mortality. Based on our findings, we recommend stricter control of CVD in cases of methotrexate discontinuation.
format Online
Article
Text
id pubmed-8602828
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-86028282021-11-20 Higher Risk of Cardiovascular Diseases in Rheumatoid Arthritis Patients Without Methotrexate Treatment Hloch, Karel Doseděl, Martin Duintjer Tebbens, Jurjen Žaloudková, Lenka Medková, Helena Vlček, Jiří Soukup, Tomáš Pávek, Petr Front Pharmacol Pharmacology Cardiovascular diseases (CVDs) lead to higher morbidity and mortality in rheumatoid arthritis; thus, we aimed to determine whether patients who had discontinued methotrexate treatment before the study enrollment (group MTX 0) were at a higher risk of CVD than patients treated with methotrexate at the time of the data collection (group MTX 1). A retrospective, prospective, observational, cross-sectional study was conducted. A total of 125 patients were enrolled in the study. Patients from the MTX 0 group (n = 35) were not treated with methotrexate for 7.54 (SD ± 4.21) years in average. Medical documentation as well as information taken in patient examinations during regular rheumatologist visits was used to obtain the required data. The composite of any CVD occurred less frequently in patients in the MTX 1 group than in the MTX 0 group (18.8 vs. 40.0%, OR 0.35, 95% CI, 0.15 to 0.83; p = 0.017) with a non-significant trend after adjustment for other treatments, which differed between study groups at the baseline (p = 0.054). Significant difference was found for the reduction of myocardial infarction in the MTX 1 group compared to the MTX 0 group (3.5 vs. 14.3%, OR 0.22, 95% CI, 0.05 to 0.97; p = 0.046). There were 4 deaths (4.7%) in the MTX 1 group as compared with 7 (20.0%) in the MTX 0 group (OR 0.20, 95% CI, 0.05 to 0.73; p = 0.015). Our results demonstrate that patients who discontinued methotrexate treatment are at a significantly higher risk of CVD and all-cause mortality. Based on our findings, we recommend stricter control of CVD in cases of methotrexate discontinuation. Frontiers Media S.A. 2021-11-05 /pmc/articles/PMC8602828/ /pubmed/34803668 http://dx.doi.org/10.3389/fphar.2021.703279 Text en Copyright © 2021 Hloch, Doseděl, Duintjer Tebbens, Žaloudková, Medková, Vlček, Soukup and Pávek. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Hloch, Karel
Doseděl, Martin
Duintjer Tebbens, Jurjen
Žaloudková, Lenka
Medková, Helena
Vlček, Jiří
Soukup, Tomáš
Pávek, Petr
Higher Risk of Cardiovascular Diseases in Rheumatoid Arthritis Patients Without Methotrexate Treatment
title Higher Risk of Cardiovascular Diseases in Rheumatoid Arthritis Patients Without Methotrexate Treatment
title_full Higher Risk of Cardiovascular Diseases in Rheumatoid Arthritis Patients Without Methotrexate Treatment
title_fullStr Higher Risk of Cardiovascular Diseases in Rheumatoid Arthritis Patients Without Methotrexate Treatment
title_full_unstemmed Higher Risk of Cardiovascular Diseases in Rheumatoid Arthritis Patients Without Methotrexate Treatment
title_short Higher Risk of Cardiovascular Diseases in Rheumatoid Arthritis Patients Without Methotrexate Treatment
title_sort higher risk of cardiovascular diseases in rheumatoid arthritis patients without methotrexate treatment
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8602828/
https://www.ncbi.nlm.nih.gov/pubmed/34803668
http://dx.doi.org/10.3389/fphar.2021.703279
work_keys_str_mv AT hlochkarel higherriskofcardiovasculardiseasesinrheumatoidarthritispatientswithoutmethotrexatetreatment
AT dosedelmartin higherriskofcardiovasculardiseasesinrheumatoidarthritispatientswithoutmethotrexatetreatment
AT duintjertebbensjurjen higherriskofcardiovasculardiseasesinrheumatoidarthritispatientswithoutmethotrexatetreatment
AT zaloudkovalenka higherriskofcardiovasculardiseasesinrheumatoidarthritispatientswithoutmethotrexatetreatment
AT medkovahelena higherriskofcardiovasculardiseasesinrheumatoidarthritispatientswithoutmethotrexatetreatment
AT vlcekjiri higherriskofcardiovasculardiseasesinrheumatoidarthritispatientswithoutmethotrexatetreatment
AT soukuptomas higherriskofcardiovasculardiseasesinrheumatoidarthritispatientswithoutmethotrexatetreatment
AT pavekpetr higherriskofcardiovasculardiseasesinrheumatoidarthritispatientswithoutmethotrexatetreatment