Authors of a prospective U.S. study report that the drug methotrexate could have a substantial survival benefit among patients with rheumatoid arthritis. This is according to the April 8, issue of The Lancet.

Rheumatoid arthritis is a chronic inflammatory disease that results in reduced life-expectancy, and is associated with cardiovascular disease, infection, and cancer. Low-dose methotrexate is the primary choice of therapy for rheumatoid arthritis, although its effect on mortality for patients with the disease is not known.

Hyon Choi from the Harvard Medical School and Harvard School of Public Health, with Frederick Wolfe from the University of Kansas School of Medicine, and colleagues examined 1,240 patients with rheumatoid arthritis over the past two decades. Of the participants, 191 individuals died during follow-up.

Patients who began treatment with methotrexate (around half of the study population) had severe rheumatoid arthritis. After adjusting for this factor, methotrexate was found to have a 60% survival benefit for all causes of mortality compared with those who did not use methotrexate, and a 70% survival benefit in cases of cardiovascular death.

Hyon Choi comments: “Our data indicate that methotrexate may provide a substantial survival benefit, largely by reducing cardiovascular mortality. This gain in life expectancy could be considered in selecting a cost-effective, disease-modifying antirheumatic drug on a long-term basis. Additionally, the survival benefit of methotrexate would set a standard against which new disease-modifying antirheumatic drugs should be compared.”