Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH)
| Autor: | Jason J. Lee, Vivian P. Bykerk, Shahin Jamal, Diane Tin, Gilles Boire, Carter Thorne, George K. Dresser, Boulos Haraoui, Carol A. Hitchon, Edward C. Keystone, Janet E. Pope |
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| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty lcsh:Diseases of the musculoskeletal system early rheumatoid arthritis Bioinformatics Gastroenterology methotrexate 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Rheumatology uric acid Internal medicine medicine Immunology and Allergy Original Research 030203 arthritis & rheumatology business.industry medicine.disease Gout 030104 developmental biology chemistry Rheumatoid arthritis Concomitant Cohort Nested case-control study Uric acid Nested case-control Methotrexate lcsh:RC925-935 business Early arthritis medicine.drug |
| Zdroj: | Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders, Vol 2016, Iss 9, Pp 37-43 (2016) Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders, Vol 9 (2016) |
| ISSN: | 1179-5441 |
| Popis: | Objectives The mechanism of action of methotrexate in rheumatoid arthritis (RA) is complex. It may increase adenosine levels by blocking its conversion to uric acid (UA). This study was done to determine if methotrexate lowers UA in early RA (ERA). Methods Data were obtained from Canadian Early Arthritis Cohort, an incident ERA cohort. All ERA patients with serial UA measurements were included, comparing those with methotrexate use vs. no methotrexate exposure (controls). Analyses were exploratory. Patients with concomitant gout or taking UA-lowering therapies were excluded. Results In total, 49 of the 2,524 ERA patients were identified with data available for both pre-methotrexate UA levels and post-methotrexate UA levels (300 μmol/L and 273 μmol/L, respectively; P = 0.035). The control group not taking methotrexate had a mean baseline UA level of 280 μmol/L and a follow-up level of 282 μmol/L ( P = 0.448); mean change in UA with methotrexate was -26.8 μmol/L vs. 2.3 μmol/L in the no methotrexate group ( P = 0.042). Methotrexate users with a decrease in UA had a disease activity score of 2.37 for 28 joints when compared with the controls (3.26) at 18 months ( P = 0.042). Methotrexate users with decreased UA had a lower swollen joint count (SJC) of 0.9 at 18 months, whereas methotrexate users without lowering of UA had an SJC of 4.5 ( P = 0.035). Other analyses were not significant. Conclusions Methotrexate response is associated with lowering of serum UA in ERA compared to nonusers. This may be due to changes in adenosine levels. Methotrexate response is associated with lower UA and fewer swollen joints compared to nonresponders. |
| Databáze: | OpenAIRE |
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