AHA 2018 | No Benefits with Methothrexate as Anti-Inflammatory Drug

Low-dose methotrexate (a nonspecific anti-inflammatory agent used for the treatment of rheumatoid arthritis and other autoimmune disorders) did not prevent cardiovascular events in patients with a prior infarction or multivessel coronary artery disease, according to this study presented at the American Heart Association (AHA) Congress and published simultaneously in the New England Journal of Medicine (NEJM).

This study, called CIRT (Cardiovascular Inflammation Reduction Trial), dashes our hopes of treating residual inflammatory risk with a relatively inexpensive drug.

Methotrexate had no effect on interleukin-1β, interleukin-6, or C-reactive protein levels as markers of inflammation.

These results contrast with the CANTOS trial, which showed that canakinumab (a human monoclonal antibody that specifically neutralizes interleukin-1β) reduces cardiovascular events when added to optimal medical therapy.

Read also: AHA 2018 | New Physical Activity Guidelines Recommend Movement for All Ages.

The CIRT study randomized patients with previous infarction or multivessel coronary artery disease in addition to type 2 diabetes or metabolic syndrome to low-dose methotrexate (15-20 mg) or placebo.

The trial was stopped due to a lack of benefit derived from the drug vs. placebo, after a mean follow-up of 2.3 years and once 4786 of the 6158 eligible patients had completed the randomization and treatment phase.

Original title: Low-Dose Methotrexate for the Prevention of Atherosclerotic Events.

Reference: Ridker PM et al. N Engl J Med. 2018; Epub ahead of print.

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