Methotrexate at middle and high accumulative doses might be associated with lower risk of new-onset cancers in patients with rheumatoid arthritis: a nationwide population-based cohort study.
cancer
cohort study
methotrexate
rheumatoid arthritis
Journal
Therapeutic advances in musculoskeletal disease
ISSN: 1759-720X
Titre abrégé: Ther Adv Musculoskelet Dis
Pays: England
ID NLM: 101517322
Informations de publication
Date de publication:
2020
2020
Historique:
received:
16
09
2019
accepted:
21
11
2020
entrez:
15
1
2021
pubmed:
16
1
2021
medline:
16
1
2021
Statut:
epublish
Résumé
We investigated whether taking methotrexate (MTX) is associated with a lower risk of new-onset cancers in patients with rheumatoid arthritis (RA). We conducted a 12-year retrospective cohort study from a population-based National Health Insurance Research Database in Taiwan. A total of 21,699 patients with newly diagnosed RA were enrolled during 2000-2009. The overall cancer rate was compared between 10,352 new users of MTX and 11,347 non-users. We used the WHO Defined Daily Dose (DDD) as a tool to assess drug exposure. Cox proportional hazard regression models were used to estimate the hazard ratio (HR) of disease after controlling for demographics and other comorbidities. After adjusting for age, sex, cancer-related comorbidities, and RA-combined medication, the HR of cancer risk was 0.87 (95% CI = 0.74-1.02) for the MTX user group compared with the MTX non-user group. The cumulative incidence of cancer in the MTX non-user group was significantly higher than that of the MTX user group (log-rank test MTX at middle and high accumulative doses might be associated with lower risk of new-onset cancers in patients with RA.
Sections du résumé
BACKGROUND
BACKGROUND
We investigated whether taking methotrexate (MTX) is associated with a lower risk of new-onset cancers in patients with rheumatoid arthritis (RA).
METHODS
METHODS
We conducted a 12-year retrospective cohort study from a population-based National Health Insurance Research Database in Taiwan. A total of 21,699 patients with newly diagnosed RA were enrolled during 2000-2009. The overall cancer rate was compared between 10,352 new users of MTX and 11,347 non-users. We used the WHO Defined Daily Dose (DDD) as a tool to assess drug exposure. Cox proportional hazard regression models were used to estimate the hazard ratio (HR) of disease after controlling for demographics and other comorbidities.
RESULTS
RESULTS
After adjusting for age, sex, cancer-related comorbidities, and RA-combined medication, the HR of cancer risk was 0.87 (95% CI = 0.74-1.02) for the MTX user group compared with the MTX non-user group. The cumulative incidence of cancer in the MTX non-user group was significantly higher than that of the MTX user group (log-rank test
CONCLUSION
CONCLUSIONS
MTX at middle and high accumulative doses might be associated with lower risk of new-onset cancers in patients with RA.
Identifiants
pubmed: 33447265
doi: 10.1177/1759720X20981221
pii: 10.1177_1759720X20981221
pmc: PMC7780328
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1759720X20981221Informations de copyright
© The Author(s), 2020.
Déclaration de conflit d'intérêts
Conflict of interest statement: The authors declare that there is no conflict of interest.
Références
J Rheumatol. 2000 May;27(5):1171-7
pubmed: 10813283
Clin Exp Rheumatol. 2017 Nov-Dec;35(6):907-912
pubmed: 28421991
Adv Enzyme Regul. 1994;34:397-419
pubmed: 7942284
Am J Med. 1985 Jan 21;78(1A):39-43
pubmed: 3970039
Int J Rheum Dis. 2019 Sep;22(9):1679-1685
pubmed: 31297986
J Rheumatol. 1996 Jun;23(6):1095-7
pubmed: 8782146
Arthritis Rheum. 1996 Feb;39(2):325-9
pubmed: 8849387
Med Oncol. 2009;26(1):1-9
pubmed: 18461290
BMC Med. 2014 Mar 18;12:48
pubmed: 24642038
JAAD Case Rep. 2016 Aug 27;2(4):354-6
pubmed: 27626055
Blood. 2002 Jun 1;99(11):3909-15
pubmed: 12010788
Arthritis Res Ther. 2015 Aug 15;17:212
pubmed: 26271620
Rheumatology (Oxford). 2013 Jan;52(1):99-110
pubmed: 23086517
Pharmacoepidemiol Drug Saf. 2006 Jul;15(7):462-8
pubmed: 16700080
Arthritis Rheum. 2006 Mar;54(3):692-701
pubmed: 16508929
Ann Rheum Dis. 2015 Jul;74(7):1360-7
pubmed: 24618265
Klin Onkol. 2012;25 Suppl 2:2S87-92
pubmed: 23581023
Arthritis Rheumatol. 2017 Apr;69(4):700-708
pubmed: 27992692
Semin Arthritis Rheum. 1997 Jun;26(6):794-804
pubmed: 9213378
Rheumatol Int. 2011 Nov;31(11):1487-92
pubmed: 20473757
Autoimmun Rev. 2014 Nov;13(11):1102-8
pubmed: 25172238
Ann Oncol. 2002 Jan;13(1):73-80
pubmed: 11863115
J Clin Oncol. 1996 Jun;14(6):1943-9
pubmed: 8656264
Arthritis Rheum. 2011 Feb;63(2):352-8
pubmed: 21279991
J Rheumatol. 2012 Feb;39(2):226-32
pubmed: 22174211
JAMA Intern Med. 2015 Nov;175(11):1839-47
pubmed: 26436523
Lancet. 2000 May 6;355(9215):1616-7
pubmed: 10821370
Eur J Cardiothorac Surg. 2018 Jun 1;53(6):1112-1117
pubmed: 29684154
Lancet Oncol. 2015 Oct;16(13):1335-43
pubmed: 26321214
Arthritis Res Ther. 2017 Nov 15;19(1):251
pubmed: 29141688
J Natl Cancer Inst. 1993 Feb 17;85(4):307-11
pubmed: 8426374
JAMA Oncol. 2016 Oct 1;2(10):1317-1325
pubmed: 27310478
Arthritis Res Ther. 2008;10(2):R45
pubmed: 18433475
Arthritis Rheum. 2008 Jun 15;59(6):794-9
pubmed: 18512713
Ann Rheum Dis. 1997 Feb;56(2):97-102
pubmed: 9068281
Clin Gastroenterol Hepatol. 2013 Dec;11(12):1601-8.e1-4
pubmed: 23872237
Clin Rheumatol. 2018 Jan;37(1):81-85
pubmed: 28508950