MTX use in the treatment of RA-associated-interstitial lung disease: a systematic review
Authors' conclusion
MTX appears to have no association with an increased risk of ILD and/or its progression in RA patients.
Study context
- Population
- Studies of RA patients reporting the effect of MTX on ILD, as a primary or secondary end point
- Participants
- 36,444 participants16 studies
- Comparison
- MTX exposure vs no MTX exposure in RA
- MTXn = 18,548
- Outcome
- ILD development and RA-ILD progression
Pooled result
As reported in the abstract
- MTX was not associated with a risk of developing ILD (nine studies)
- MTX was not associated with the progression of RA-ILD (five studies)
Further pooled results
Lung function
- Accelerated decline in lung function with low-dose MTX (one study)
Survival
- Better survival in MTX vs N-MTX (one study)
Safety
- MTX use significantly associated with development of acute exacerbations (one study)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
MTX use in the treatment of RA-associated-interstitial lung disease: a systematic review. Rheumatology (Oxford). Published 24 October 2025. doi:10.
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