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

doi:10.1177/1759720X20981221

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/24896

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/24896

Title:	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
Authors:	Perng, WT;Hung, YM;Chang, RN;Lin, CL;Chiou, JY;Chen, HH;Kao, CH;Wei, JCC
Keywords:	cancer;cohort study;methotrexate;rheumatoid arthritis
Date:	2020
Issue Date:	2022-08-09T08:09:45Z (UTC)
Publisher:	SAGE PUBLICATIONS LTD
ISSN:	1759-720X
Abstract:	Background: We investigated whether taking methotrexate (MTX) is associated with a lower risk of new-onset cancers in patients with rheumatoid arthritis (RA). 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: 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 p < 0.001). In the low accumulative dose group [cumulative dose <1125 mg, cumulative defined daily dose (cDDD) <450], the HR of cancer risk for MTX users was 1.20 (95% CI = 1.01-1.42) compared with the MTX-non-user group. However, the adjusted HR of cancer risk was reduced to 0.66 (95% CI = 0.49-0.87) in MTX middle-dose users (cumulative dose 1125-2250 mg, cDDD: 450-899) and 0.33 (95% CI = 0.23-0.48) for the MTX high-dose group (cumulative dose > 2250 mg, cDDD > 900), respectively (p for trend < 0.0001). Conclusion: MTX at middle and high accumulative doses might be associated with lower risk of new-onset cancers in patients with RA.
URI:	http://dx.doi.org/10.1177/1759720X20981221 https://www.webofscience.com/wos/woscc/full-record/WOS:000605593000001 https://ir.csmu.edu.tw:8080/handle/310902500/24896
Relation:	THERAPEUTIC ADVANCES IN MUSCULOSKELETAL DISEASE ,2020 ,v12
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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