ArticleBMJ (Clinical research ed.)2023
Risk stratified monitoring for methotrexate toxicity in immune mediated inflammatory diseases: prognostic model development and validation using primary care data from the UK.
Article in BMJ (Clinical research ed.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07512401 (Safety of Reduced Methotrexate Lab Monitoring), which is not on this map. Cited by 15 papers, 2 of them syntheses that pooled 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.
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.
Safety of Reduced Methotrexate Lab Monitoring: a Population-based, Target Trial Emulation Study
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Blood-test monitoring strategies for patients established on immune-suppressing drugs: a mixed-methods study.Health technology assessment (Winchester, England) · 2026Pooled it
- Patient and Public Involvement in Pharmacoepidemiological Research: An Environmental Scan of an Emerging Area.Pharmacoepidemiology and drug safety · 2025Pooled it
- Changing mindsets about methotrexate in the rheumatology clinic to reduce side effects and improve adherence: a randomized controlled trial.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025Trial
- Prediction model for aortic dissection, aortic aneurysm, and peripheral artery disease.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- From prediction to action: developing a risk-stratified management tool for children with new-onset tic disorders.Scientific reports · 2026Article
- Methotrexate in the management of Crohn's disease: A practice survey of gastroenterologists in France.World journal of gastroenterology · 2025Article
- Advancements in pharmacological interventions for atopic dermatitis current strategies and future directions.Inflammopharmacology · 2025Review
- Patient and health professional views on risk-stratified monitoring of immune-suppressing treatment in adults with inflammatory diseases.Rheumatology (Oxford, England) · 2025Article
- Acute Transient Aminotransferase Elevation is Common With Intrathecal Methotrexate, but Liver Injury is Infrequent.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Idiopathic Granulomatous Mastitis: Immune-Pathogen Imbalance in a Treatment-Resistant Benign Inflammatory Disease.International journal of women's health · 2025Review
- Uveitis in the Pediatric Population and Therapeutic Management: A Current Literature Review.Children (Basel, Switzerland) · 2024Review
- Acute exacerbation of idiopathic pulmonary fibrosis disease: a diagnosis model in China.European journal of medical research · 2024Article
- Risk-stratified monitoring for sulfasalazine toxicity: prognostic model development and validation.RMD open · 2024Article
- The prescription and monitoring of conventional synthetic disease-modifying anti-rheumatic drugs: British Society for Rheumatology guideline scope.Rheumatology advances in practice · 2024Review
- Risk-stratified monitoring for thiopurine toxicity in immune-mediated inflammatory diseases: prognostic model development, validation, and, health economic evaluation.EClinicalMedicine · 2023Article
Corrections and comments
- Commented on by
Authors and funding
12 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo develop and validate a prognostic model to inform risk stratified decisions on frequency of monitoring blood tests during long term methotrexate treatment.
designRetrospective cohort study.
settingElectronic health records within the UK's Clinical Practice Research Datalink (CPRD) Gold and CPRD Aurum.
participantsAdults (≥18 years) with a diagnosis of an immune mediated inflammatory disease who were prescribed methotrexate by their general practitioner for six months or more during 2007-19.
main outcome measureDiscontinuation of methotrexate owing to abnormal monitoring blood test result. Patients were followed-up from six months after their first prescription for methotrexate in primary care to the earliest of outcome, drug discontinuation for any other reason, leaving the practice, last data collection from the practice, death, five years, or 31 December 2019. Cox regression was performed to develop the risk equation, with bootstrapping used to shrink predictor effects for optimism. Multiple imputation handled missing predictor data. Model performance was assessed in terms of calibration and discrimination.
resultsData from 13 110 (854 events) and 23 999 (1486 events) participants were included in the development and validation cohorts, respectively. 11 candidate predictors (17 parameters) were included. In the development dataset, the optimism adjusted R
conclusionA prognostic model was developed and validated that uses information collected during routine clinical care and may be used to risk stratify the frequency of monitoring blood test during long term methotrexate treatment.
Indexed as
Identifiers
What OpenQuestion holds
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.