TY - JOUR T1 - Methotrexate and risk of Lung disease in Rheumatoid Arthritis: A nationwide population-based cohort study from Denmark JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.4574 VL - 56 IS - suppl 64 SP - 4574 AU - Saher Burhan Shaker AU - Else Helene Ibfelt AU - Rikke Kart Jacobsen AU - Tine Iskov Kopp AU - René Lindholm Cordtz AU - Anna Svarre Jakobsen AU - Niels Seersholm AU - Lene Dreyer Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/4574.abstract N2 - Background: Methotrexate (MTX) is the most commonly recommended disease-modifying anti-rheumatic drug (DMARD) for first-line treatment of rheumatoid arthritis (RA); however, MTX has been suspected to cause lung disease as an adverse effect.Objectives: To investigate the risk of interstitial lung disease (ILD) and acute and chronic respiratory failure in RA patients treated with MTX and other medications.Methods: From the Danish National Patient Register (NPR) and the clinical DANBIO register for rheumatic diseases, we retrieved data on 30,512 RA patients registered between 1997 and 2015. Information on ILD and respiratory failure was obtained from NPR. Information on age and gender for all Danish citizens was obtained from the Danish Civil Registration System. MTX and other medication purchases were retrieved from the Danish Prescription Register. Associations between MTX and lung disease outcomes were analyzed in Cox regression models with adjustment for age, calendar time, gender and other medications. Standardized Incidence Ratios (SIRs) of lung disease were calculated to compare RA patients to the general population.Results: There was no increased risk of lung disease with MTX treatment (one or more purchases compared to no purchases), HR (95% CI) 1.00 (0.78-1.27) for ILD and 0.54 (0.43-0.67) for respiratory failure at 5-year follow-up. SIR was 3-4 times increased for ILD in MTX treated RA patients but at the same level for the whole RA population compared to the background population.Conclusion: RA patients had an increased risk of ILD compared to the general population, but there was no further increased risk associated with MTX treatment.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4574.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -