Effect of methotrexate on pulmonary function in patients with rheumatoid arthritis--a prospective study.
If given in high doses, methotrexate (MTX), a folate antagonist, could cause pulmonary complications. To evaluate the pulmonary effects of low-dose methotrexate, 55 newly diagnosed patients with rheumatoid arthritis (RA) prescribed with MTX were studied prospectively. A significant reduction in percent predicted values of forced expiratory volume (FEV(1)), forced vital capacity (FVC), total lung capacity (TLC), and functional residual capacity (FRC) was observed after 2 years of MTX treatment. A significant increase in the FEV(1):FVC ratio was also observed. In comparison to the normal annual decline in healthy adults, the actual reduction in observed values in the patients was significantly greater (3.2, 6.3, and 6.7 times normal for FEV(1), FVC, and TLC, respectively). PaO(2) and oxygen saturation showed marginal but significant improvement. It was concluded that low-dose MTX treatment in RA might cause an accelerated decline in lung function. Therefore, periodic monitoring of pulmonary function among RA patients started on MTX could be necessary.
Khadadah
M E
ME
Department of Medicine, Faculty of Medicine, Kuwait University, PO Box 24923 Safat 13110, Kuwait. mousa@hsc.kuniv.edu.kw
Jayakrishnan
B
B
Al-Gorair
S
S
Al-Mutairi
M
M
Al-Maradni
N
N
Onadeko
B
B
Malaviya
A N
AN
D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy*; D016022:Case-Control Studies; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000187:drug effects*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D008727:Methotrexate