Vasculitis & polymyalgia rheumatica
Azathioprine vs methotrexate in eosinophilic granulomatosis with polyangiitis: a monocentric retrospective study
Authors' conclusion
A significant proportion of patients achieved remission with both MTX and AZA. MTX1 had an earlier remission on a lower GC dose but MTX2 had a better steroid-sparing effect.
Study context
- Population
- Patients with EGPA treated with AZA or MTX, single centre4 treatment groups
- Participants
- 57 patients
- Exposure
- MTX vs AZA as first-line agents in non-severe disease or as second-line maintenance after CYC/rituximab in severe disease
- Outcome
- Remission rate R1 (BVAS = 0)
- Follow-up
- First 5 years of treatment
Methodological detailsmonocentric
- Monocentric
Main finding
As reported in the abstract
MTX1 vs AZA1: P = 0.53 · MTX2 vs AZA2: P = 0.23
Observational data: associations, not effects.
Further findings
| Outcome | MTX1 | AZA1 | MTX2 | AZA2 | P value |
|---|---|---|---|---|---|
| Remission R2 (BVAS = 0 with prednisone ≤5 mg/day) · first 6 monthsMTX1 vs AZA1 | 54% | 12% | — not stated in the abstract | — not stated in the abstract | P = 0.04 |
| Remission R3 (MIRRA: BVAS = 0 with prednisone ≤3.75 mg/day) · up to first 18 monthsMTX1 vs AZA1 | 35% | 0 events | — not stated in the abstract | — not stated in the abstract | P = 0.07 |
| Cumulative GC dose · 5 yearsMTX2 vs AZA2 | — not stated in the abstract | — not stated in the abstract | 6 g | 10.7 g | P = 0.03 |
| Asthma/ENT relapsesAZA2 vs MTX2 | — not stated in the abstract | — not stated in the abstract | 64% | 23% | P = 0.04 |
— not stated in the abstract
Time-to-first relapse
- No differences emerged in time-to-first relapse
Safety
Adverse events
P = 0.004
Adverse events
- Without affecting the suspension rate
Original publication
Azathioprine vs methotrexate in eosinophilic granulomatosis with polyangiitis: a monocentric retrospective study. Rheumatology (Oxford). Published 16 June 2023. doi:10.
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