Evidence map›Paper›PMID 19060002›Full record

SynthesisAnnals of the rheumatic diseases2009

Long-term safety of methotrexate monotherapy in patients with rheumatoid arthritis: a systematic literature research.

C Salliot, D van der Heijde

2 registry-linked trialsOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of the rheumatic diseases, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 266 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
266citing papers in PubMed, 9 pooled it
16.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02528435 completednot on this mapstarted 2013, after this paper: background citation

Role of Pharmacogenetic and Psychological Factors in Methotrexate Tolerance: Studies in Children With Chronic Arthritis and Children With Leukemia

TypeobservationalSponsorUniversity of AarhusRan2013 to 2017Enrolled145ConditionsJuvenile Idiopathic Arthritis, ALL
NCT03736161 phase3completednot on this mapstarted 2017, after this paper: background citation

Safety and Efficacy of Tofacitinib vs Methotrexate in the Treatment of Psoriatic Arthritis

TypeinterventionalSponsorGlobe Pharmaceuticals LimitedRan2017 to 2019Enrolled61ConditionsPsoriatic ArthritisArmsGroup A- Tofacitinib, Group B- Methotrexate
3 · Its place in the literature

Who cites it

266 citing papers in PubMed, 9 syntheses or guidelines pooled it, 661 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Guideline
  9. Pooled it
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

206 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 2 countries.

C SalliotParis Descartes University, Medicine Faculty, Rheumatology B Department, Cochin Hospital, Paris, France. carinesalliot@gmail.com
D van der Heijde
Hôpital Cochin · FRLeiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo perform a systematic literature review of the long-term safety of methotrexate (MTX) monotherapy in rheumatoid arthritis (RA).

methodsA search was performed in Medline, Cochrane and EMBASE. Adults with RA who had received MTX monotherapy for more than 2 years were studied.

results88 published studies were included. Over 12 years of treatment, the termination rate of MTX due to toxicity was less than for sulfasalazine, gold, d-penicillamine and higher than for hydroxychloroquine (level of evidence 2a-2b). Long-term use of MTX does not appear to be a risk factor for serious infections, including herpes zoster (2b-4), and could provide a survival benefit by reducing cardiovascular mortality (2b). The prevalence of raised liver enzymes (more than twice the upper limit of normal) is close to 13% of patients; 3.7% of patients stopped MTX permanently owing to liver toxicity (2b). Data on the risk for liver fibrosis/cirrhosis are conflicting: a meta-analysis showed an incidence of fibrosis of 2.7% after 4 years of MTX (2a). However, two other studies on sequential liver biopsies did not show evidence for developing severe damage (2b). Insufficient data are available to fully assess the risk of lymphoma and malignancies, although there is no strong evidence of increased risk (2b-4).

conclusionThis systematic literature search on MTX monotherapy with relatively low-dose use during at least 2 years shows favourable long-term safety.

Indexed as

AdultAntirheumatic AgentsArthritis, RheumatoidCardiovascular DiseasesChemical and Drug Induced Liver InjuryHumansInfectionsLong-Term CareMethotrexateNeoplasmsPneumoniaRisk FactorsAntirheumatic AgentsMethotrexate

Identifiers

PMID19060002
PMCPMC2689525
OpenAlexW2133103918

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.