Risk of chronic obstructive pulmonary disease exacerbation in patients who use methotrexate—a nationwide study of 58,580 outpatients
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Risk of chronic obstructive pulmonary disease exacerbation in patients who use methotrexate—a nationwide study of 58,580 outpatients. / Bergsøe, Christina Marisa; Sivapalan, Pradeesh; Saeed, Mohamad Isam; Eklöf, Josefin; Saghir, Zaigham; Sørensen, Rikke; Biering-Sørensen, Tor; Jensen, Jens Ulrik Stæhr.
I: Biomedicines, Bind 9, Nr. 6, 604, 2021.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Risk of chronic obstructive pulmonary disease exacerbation in patients who use methotrexate—a nationwide study of 58,580 outpatients
AU - Bergsøe, Christina Marisa
AU - Sivapalan, Pradeesh
AU - Saeed, Mohamad Isam
AU - Eklöf, Josefin
AU - Saghir, Zaigham
AU - Sørensen, Rikke
AU - Biering-Sørensen, Tor
AU - Jensen, Jens Ulrik Stæhr
N1 - Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021
Y1 - 2021
N2 - Patients with severe chronic obstructive pulmonary disease (COPD) experience frequent acute exacerbations and require repeated courses of corticosteroid therapy, which may lead to adverse effects. Methotrexate (MTX) has anti-inflammatory properties. The objective of this study was to describe the risk of COPD exacerbation in patients exposed to MTX. In this nationwide cohort study of 58,580 COPD outpatients, we compared the risk of hospitalization-requiring COPD exacerbation or death within 180 days in MTX vs. non-MTX users in a propensity-score matched study population as well as an unmatched cohort, in which we adjusted for confounders. The use of MTX was associated with a reduction in risk of COPD exacerbation in the propensity-score matched population at 180 days follow-up (HR 0.66, CI 0.66–0.66, p < 0.001). Similar results were shown in our sensitivity analyses at 180-day follow-up on unmatched population and 365-day follow-up on matched and unmatched population (HR 0.76 CI 0.59–0.99, HR 0.81 CI 0.81–0.82 and HR 0.92 CI 0.76–1.11, respectively). MTX was associated with a lower risk of COPD exacerbation within the first six months after study entry. The finding seems biologically plausible and could potentially be a part of the management of COPD patients with many exacerbations.
AB - Patients with severe chronic obstructive pulmonary disease (COPD) experience frequent acute exacerbations and require repeated courses of corticosteroid therapy, which may lead to adverse effects. Methotrexate (MTX) has anti-inflammatory properties. The objective of this study was to describe the risk of COPD exacerbation in patients exposed to MTX. In this nationwide cohort study of 58,580 COPD outpatients, we compared the risk of hospitalization-requiring COPD exacerbation or death within 180 days in MTX vs. non-MTX users in a propensity-score matched study population as well as an unmatched cohort, in which we adjusted for confounders. The use of MTX was associated with a reduction in risk of COPD exacerbation in the propensity-score matched population at 180 days follow-up (HR 0.66, CI 0.66–0.66, p < 0.001). Similar results were shown in our sensitivity analyses at 180-day follow-up on unmatched population and 365-day follow-up on matched and unmatched population (HR 0.76 CI 0.59–0.99, HR 0.81 CI 0.81–0.82 and HR 0.92 CI 0.76–1.11, respectively). MTX was associated with a lower risk of COPD exacerbation within the first six months after study entry. The finding seems biologically plausible and could potentially be a part of the management of COPD patients with many exacerbations.
KW - Airway inflammation
KW - Anti-inflammatory
KW - Chronic obstructive pulmonary disease
KW - Exacerbation of chronic obstructive pulmonary disease
KW - Immunosuppression
U2 - 10.3390/biomedicines9060604
DO - 10.3390/biomedicines9060604
M3 - Journal article
C2 - 34073252
AN - SCOPUS:85107745822
VL - 9
JO - Biomedicines
JF - Biomedicines
SN - 2227-9059
IS - 6
M1 - 604
ER -
ID: 273646969