Content » Vol 92, Issue 4

Investigative Report

Methotrexate Reduces the Occurrence of Cerebrovascular Events among Taiwanese Psoriatic Patients: A Nationwide Population-based Study

Cheng-Che E. Lan, Ying-Chin Ko, Hsin-Su Yu, Ching-Shuang Wu, Wan-Chen Li, Yi-Wei Lu, Yin-Chun Chen, Yi-Ying Chin, Yi-Hsin Yang, Gwo-Shing Chen
DOI: 10.2340/00015555-1283

Abstract

Psoriasis is a chronic inflammatory disease. The aim of this study was to evaluate the effects of methotrexate and retinoid on risks for developing cerebrovascular disease among psoriatic patients. A population-based nested case-control study was conducted using the Taiwanese National Health Insurance database. Cox proportional hazards models were adopted. The hazard ratio (HR) of newly developed cerebrovascular disease was 1.28 (95% confidence interval (CI) = 1.162–1.413; p < 0.0001) for psoriatic vs. non-psoriatic subjects. In terms of the effects of methotrexate or retinoid on the occurrence of cerebrovascular disease, a significant protection effect (HR = 0.50; 95% CI = 0.27–0.92; p = 0.0264) was found for patients with methotrexate prescription. Retinoid prescription showed no protective effect. Further analyses revealed that a low cumulative methotrexate dose is associated with significant protective effect (HR = 0.53; 95% CI = 0.28–1.00; p = 0.0486) while a high cumulative dose was not (HR 0.80; 95% CI = 0.11–5.68; p = 0.8214). These results suggest that psoriatic patients receiving low-dose methotrexate treatment may have reduced risk for developing cerebrovascular disease. Further prospective study should be performed to validate the vasculoprotective effect of this treatment strategy.

Significance

Supplementary content

Comments

Not logged in! You need to login/create an account to comment on articles. Click here to login/create an account.