Methotrexate may protect rheumatoid arthritis patients against heart disease

Published on 30 Nov 2009

A review of published research has suggested that the drug methotrexate may help to reduce the risk of cardiovascular disease in people with rheumatoid arthritis.

Methotrexate is a disease-modifying anti-rheumatic drug (DMARD) that helps to reduce pain, swelling and stiffness.

It also helps to suppress the chronic inflammation experienced by people with rheumatoid arthritis, an autoimmune disease in which the body attacks itself.

Research has shown that this inflammation places people with rheumatoid arthritis at an increased risk of cardiovascular disease.

Since methotrexate helps to combat chronic inflammation, UK researchers set out to find out whether the drug also reduces patients' elevated risk of heart disease.

The team - which included researchers from Poole Hospital, Southampton University, St Georges Healthcare NHS Trust in London, Hull York Medical School, King's College London and Cambridge University - carried out a systematic literature review to identify relevant studies.

This uncovered 18 pieces of research which were published between 1980 and 2008 and looked at the relationship between methotrexate use and cardiovascular disease in patients with rheumatoid arthritis.

Two of the studies had looked at the relationship between methotrexate use and deaths from cardiovascular disease, one of which showed a significant reduction in death rates while the other showed a promising trend.

Existing research also suggests that people who had used methotrexate during the year prior to their diagnosis of rheumatoid arthritis - for instance as an anti-cancer therapy - were less likely to develop cardiovascular disease over the next three to four years.

Writing in the journal Rheumatology, the researchers revealed: "The current evidence suggests that methotrexate use is associated with a reduced risk of cardiovascular disease events in patients with rheumatoid arthritis.

"This suggests that reducing the inflammation in rheumatoid arthritis using methotrexate not only improves disease-specific outcomes but may also reduce collateral damage such as atherosclerosis."

A spokeswoman for the Arthritis Research Campaign said that methotrexate and also steroids were known to reduce the amount of inflammation in rheumatoid arthritis.

The charity is currently co-funding a trial with the British Heart Foundation to establish if more people with rheumatoid arthritis would benefit from taking cholesterol-lowering drugs called statins to cut cardiovascular-related deaths.