Association of pulmonary fibrosis with Methotrexate in Rheumatoid Arthritis patients

Volume 15 , Issue 2 , December 2025 , Pages 183-194

Authors

Soma Hassan 1 ; Niaz Jwad Albarzinji 2

1 Department of internal medicine/ Rheumatology Institute/ hawler medical university, Erbil, Kurdistan Region of Iraq

2 Department of Internal Medicine/ Rheumatology Institute/Hawler Medical University, Erbil, Kurdistan Region, Iraq.

DOI logo 10.17656/jsmc.10502

Keywords

Abstract

Background: Rheumatoid Arthritis (RA) is a chronic autoimmune inflammatory disease that affects joints and can lead to extra-articular manifestations, including pulmonary fibrosis (PF). Methotrexate (MTX), commonly used in RA treatment, has been associated with lung complications, though its role in the development of PF remains unclear. Objective: The current study investigates the association between methotrexate use and pulmonary fibrosis in RA patients, focusing on clinical, sociodemographic, and treatment-related factors. Patients and Methods: A cross-sectional study was conducted from October 2024 to March 2025 at the outpatient rheumatology clinic of Rizgary General Teaching Hospital, Erbil, Iraq. A total of 86 RA patients were enrolled, with inclusion criteria of RA diagnosis for at least one year and MTX or other DMARD use. Pulmonary assessments with HRCT scans. Results: The prevalence of pulmonary fibrosis was 14.0% (12 out of 86 patients). RA-PF patients were significantly older (63.67 ± 9.98 years) compared to RA-non-PF patients (55.89 ± 12.65 years, P = 0.046). The gender distribution was also significantly different, with fewer females in the RA-PF group (66.7% vs. 93.2%, P = 0.019). Disease duration greater than 5 years was seen in 75% of RA-PF patients, compared to 43.2% in RA-non-PF (P = 0.041). MTX (10-20 mg) was used by 91.7% of RA-PF patients compared to 62.2% of RA-non-PF patients (P = 0.045). The mean duration of MTX use was similar between groups (2.38 ± 2.68 years in RA-PF vs. 2.21 ± 2.88 years in RA-non-PF, P = 0.673). Inflammatory markers showed significantly higher levels

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  • First online21 December 2025
  • Published at21 December 2025

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