ArticleArthritis research & therapy2025
Methotrexate-related drug reactions on kidneys and liver in rheumatoid arthritis: an analysis of spontaneous reports in EudraVigilance.
Article in Arthritis research & therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Agranulocytosis associated with metamizole among EudraVigilance reports involving methotrexate for rheumatoid arthritis.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Geroscience insights into difficult-to-treat rheumatoid arthritis: the role of unhealthy aging, comorbidity, and therapeutic complexity.GeroScience · 2026Review
- Microneedle patches deliver targeted GLP-1RAs-loaded nanoparticles for the treatment of rheumatoid arthritis.Journal of nanobiotechnology · 2026Article
- Article
- Nanomedicine-Driven Therapeutic Strategies for Rheumatoid Arthritis-Associated Depression: Mechanisms and Pharmacological Progress.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Methotrexate-induced pancytopenia: clinical characteristics, medication errors, and outcomes in a tertiary care centre: a retrospective single-centre study.Rheumatology international · 2025Article
- Beyond joints: the importance of animal models in exploring rheumatoid arthritis comorbidities.Frontiers in medicine · 2025Review
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4 authors.
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Abstract
objectiveMethotrexate (MTX), a standard treatment for rheumatoid arthritis (RA), is known for its potential kidney and liver toxicity. Whether concomitant use of analgesics, possibly affecting the same organs, has an impact on the occurrence or course of adverse drug reactions (ADRs) remains unclear.
methodsWe used all spontaneous reports (until 2022) of suspected ADRs associated with MTX in RA patients, from the EudraVigilance database, a spontaneous report system operated by the European Medicines Agency (EMA). We displayed case and treatment characteristics, stratified by the organ affected (kidneys, liver) and the outcome (fatal, non-fatal).
resultsWe included a total of 10,319 reports (mean age: 62.3 years, 72.6% female). 365 and 1,082 were related to ADRs involving the kidneys and liver, respectively. Patients with ADRs on the kidneys were older and comedication (e.g. non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, metamizole and corticosteroids) was more common than in cases with ADRs on the liver. More patients with kidney- than liver-related ADRs had a fatal outcome (21.1% vs. 5.8%). In fatal cases with ADRs on the kidneys and with ADRs on the liver comedication was more common compared to non-fatal cases.
conclusionLiver dysfunction was reported nearly three times more often than renal impairment. However, the kidneys need to be especially watched for, since a fatal outcome was considerably more common in renal failure. More precise and standardized recommendations on renal function tests might be necessary to support physicians in the complex treatment of RA.
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