Methotrexate osteopathy in long-term, low-dose methotrexate treatment for psoriasis and rheumatoid arthritis

No deleterious effect of low dose methotrexate on titanium implant osseointegration in a rabbit model

“…Our data confirms and extends previous observations that low dose MTX does not have a negative effect on BMD in patients with RA and psoriasis 32,33. The complete exclusion of disease interference in our model allows for an accurate conclusion regarding the lack of a deleterious effect of this drug on bone mass at either cortical or trabecular sites.…”

“…The causal relationship is still under debate since these five patients had other important risk factors for osteoporotic fractures, emphasizing the relevance of the present study 29. In addition, the observation period in the present study was an appropriate exposure time to the drug considering the comparative life spans of rabbits and humans,30,31 which is relevant since MTX-osteopathy in adults is associated with prolonged periods of therapy 28,32. …”

Bone tissue as the site of action of oncological drugs

“…Reduction in the bone mineral density (BMD) has been observed as well as qualitative features of osteopenia, seen in radiograms as shrinking of the cortical bone, lower Singh index, more distinct (due to thinning) trabeculae or -in contrast -lack of the trabecular structure in imaging. Similar reports have been published based on observations in patients treated with MTX for collagenoses [9][10][11][12][13][14][15][16][17]. Apart from clinical symptoms, there was also described in this group of patients inhibition of osteoblast activity [13], as well as a significant reduction in osteocalcin synthesis by osteoblasts [14] -seen in both of the above studies after a weekly administration of MTX at low doses.…”

Anti-CCP-positive patients with RA have a higher 10-year probability of fracture evaluated by FRAX®: a registry study of RA with osteoporosis/fracture

“…The first one is the differences in the enrolled populations in the aforementioned studies. All regimens, including glucocorticoids [ 5 ], conventional DMARDs [ 19 ], and bDMARDs [ 20 , 21 ], used to treat RA revealed a BMD-modulating effect. After long-term treatment of patients with established RA, BMD may vary depending on which regimen or how long the regimens are used.…”