PMID- 30583473
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 8
IP  - 1
DP  - 2018 Dec 21
TI  - Risk of Infection with Methotrexate Therapy in Inflammatory Diseases: A 
      Systematic Review and Meta-Analysis.
LID - 10.3390/jcm8010015 [doi]
LID - 15
AB  - The aim of this study was to determine the risk of infection in adults with 
      inflammatory rheumatic diseases (IRDs) treated with methotrexate. We performed a 
      systematic review and meta-analysis of randomized controlled trials (RCTs) 
      assessing methotrexate versus placebo in adults using MEDLINE, EMBASE, and 
      CENTRAL databases from 1980 to August 2017. The primary outcome was the risk of 
      infection associated with methotrexate therapy. We chose a random effect model to 
      summarize adverse event outcomes as risk ratios (RRs) and related 95% confidence 
      intervals (95% CI). Twelve RCTs (total patients 1146) met the inclusion criteria 
      for our main analysis, and ten for risk of serious infection (total patients 
      906). Overall, methotrexate was associated with increased risk of infection in 
      rheumatoid arthritis (RA) (RR: 1.25; 95% CI, 1.01(-)1.56; p = 0.04; I(2) = 0%), but 
      not in other non-RA IRD populations. There was no increased risk of total 
      infections (RR: 1.14; 95% CI, 0.98(-)1.34; p = 0.10; I(2) = 0%) or serious infections 
      (RR: 0.76; 95% CI, 0.11(-)5.15; p = 0.78; I(2) = 0%) in all included IRDs. 
      Conclusively, methotrexate use in IRDs is associated with a higher risk of all 
      infections in RA, but not in other non-RA (IRD) populations. There is no 
      increased risk of serious infections.
FAU - Ibrahim, Ammar
AU  - Ibrahim A
AD  - Department of Medicine, National University of Ireland Galway, Galway, Ireland. 
      ammar.ibrahim@nuigalway.ie.
FAU - Ahmed, Mohammed
AU  - Ahmed M
AD  - Department of Medicine, National University of Ireland Galway, Galway, Ireland. 
      jamaleldeen@gmail.com.
FAU - Conway, Richard
AU  - Conway R
AUID- ORCID: 0000-0003-2538-3362
AD  - Department of Rheumatic Diseases, St. James's University Hospital, Dublin, 
      Ireland. drrichardconway@gmail.com.
FAU - Carey, John J
AU  - Carey JJ
AUID- ORCID: 0000-0001-7292-2328
AD  - Department of Rheumatic Diseases, Galway University Hospitals, Galway, Ireland. 
      john.j.carey@nuigalway.ie.
LA  - eng
PT  - Journal Article
DEP - 20181221
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC6352130
OTO - NOTNLM
OT  - DMARDs
OT  - infections and arthritis
OT  - inflammation
OT  - methotrexate
COIS- The authors declare no conflict of interest.
EDAT- 2018/12/26 06:00
MHDA- 2018/12/26 06:01
PMCR- 2018/12/21
CRDT- 2018/12/26 06:00
PHST- 2018/11/16 00:00 [received]
PHST- 2018/12/12 00:00 [revised]
PHST- 2018/12/15 00:00 [accepted]
PHST- 2018/12/26 06:00 [entrez]
PHST- 2018/12/26 06:00 [pubmed]
PHST- 2018/12/26 06:01 [medline]
PHST- 2018/12/21 00:00 [pmc-release]
AID - jcm8010015 [pii]
AID - jcm-08-00015 [pii]
AID - 10.3390/jcm8010015 [doi]
PST - epublish
SO  - J Clin Med. 2018 Dec 21;8(1):15. doi: 10.3390/jcm8010015.