TOPLINE:
The use of low-dose methotrexate among older adults with chronic kidney disease (CKD) was associated with a significantly increased risk at 90 days for serious adverse events requiring a hospital visit, compared with starting treatment with hydroxychloroquine.
METHODOLOGY:
In a retrospective, population-based cohort study conducted in Ontario, Canada, researchers used linked administrative healthcare data to identify adults aged 66 years and older with CKD who were not undergoing dialysis and were new to medication; CKD was defined as an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73m2.
The study population included 2309 individuals who began treatment with low-dose methotrexate (5–35 mg/wk); they were matched with 2309 individuals who began treatment with hydroxychloroquine (200-400 mg/d). The median age was 76 years, 69% were women, and rheumatoid arthritis was the most common diagnosis (56%).
The primary outcome was the risk of a hospital visit at 90 days for a composite of serious adverse events that included myelosuppression, sepsis, pneumotoxic effects, or hepatoxic effects.
TAKEAWAY:
Overall, 3.55% of methotrexate patients and 1.73% of hydroxychloroquine patients met the primary outcome (risk ratio, 2.05); these events occurred at a median of 49 days and 43 days after starting the medications for the two groups, respectively.
