Methotrexate Use Linked to Lower Infection Risk in Early RA
In patients with early rheumatoid arthritis (RA), methotrexate-based strategies were associated with a lower risk for serious infections compared with strategies using other conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). Increasing age, smoking, and comorbidities were identified as important predictors of an increased risk for serious infections.
METHODOLOGY:
Researchers conducted an observational cohort study to assess the risk for serious infections among patients with early RA on the basis of prescribed treatment strategies.
They used audit data of 17,472 adults with newly diagnosed RA (mean age, 59 years; 63% women) in England and Wales between May 2018 and April 2023.
At 3 months, 63% of patients had initiated methotrexate-based therapy (either as monotherapy or in combination with another csDMARD), 26% had initiated other csDMARDs, and 11% had delayed initiating csDMARDs. Additionally, 79% were on concomitant corticosteroids as part of the initial treatment regimen.
The primary outcome was a serious infection event, defined as an infection requiring hospitalization or resulting in death, assessed over a mean follow-up duration of 2.62 years.
TAKEAWAY:
The overall incidence rate of serious infections was 3.02 per 100 person-years; 41% of these infections were respiratory infections, followed by COVID (15%) and sepsis/bacteraemia (12%).
Patients on methotrexate regimens had a 24% lower risk for serious infections than those on other csDMARDs (adjusted hazard ratio, 0.76; P < .001).
< .001). Factors associated with an increased risk for serious infections included increasing age, current or past smoking, comorbidities (diabetes, lung disease, and hypertension), seropositivity for rheumatoid factor, and higher baseline disease severity ( P < .01 for all).
< .01 for all). Patients who did not initiate csDMARDs at diagnosis had a higher incidence rate of serious infections than those who initiated csDMARDs.
IN PRACTICE:
"Channelling bias due to residual confounding is likely part of this explanation, but our data still suggest that avoidance of methotrexate because of concerns surrounding serious infection risk are not strongly supported by evidence," the authors wrote.
SOURCE:
This study was led by Maryam A. Adas, Centre for Rheumatic Disease, King's College London, London, England. It was published online on June 5, 2025, in Rheumatology .
LIMITATIONS:
Data on treatment with csDMARDs were available only at diagnosis and up to 3 months, preventing assessment of subsequent drug transitions or continuations. Certain confounding factors, such as the type or severity of lung disease, were not captured. Data on treatment adherence, steroid dosing, and the route of treatment administration were unavailable.
DISCLOSURES:
This study received no specific funding. One author reported receiving consulting fees and research grant income from pharmaceutical companies, including UCB and BMS. Several other authors reported receiving honoraria or speaker fees, holding positions, or having other financial ties with multiple companies.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
CNN
35 minutes ago
- CNN
Fingerprint of human-caused global warming was likely detectable 140 years ago, far earlier than previously thought
The human fingerprint on global warming was likely evident in Earth's atmosphere far earlier than previously thought—even before the invention of modern cars, a new study says. Using a combination of scientific theory, modern observations and multiple, sophisticated computer models, researchers found a clear signal of human-caused climate change was likely discernible with high confidence as early as 1885, just before the advent of gas-powered cars but after the dawn of the industrial revolution. The findings, detailed in a paper published Monday in the journal Proceedings of the National Academy of Sciences, raise the likelihood that humanity has been remaking the planet's climate in a detectable way for longer than previously believed—and highlight the importance of tracking changes in the upper atmosphere. Scientists had begun to record surface temperature observations by the mid-19th century. The start date for a detectable human signal in surface temperatures has generally been thought to be in the early-to-mid-20th century, though other parts of the climate system showed signs of change at different times. For this study, the veteran climate researchers posed the question: With the observational tools of today, when is the earliest that the signs of human-caused climate change would have been detectable in the atmosphere? The study looked specifically at signals in the stratosphere – the second level of the atmosphere. Most weather occurs in the lowest level, the troposphere. While greenhouse gas emissions warm the lower atmosphere, they exert the opposite effect on the stratosphere, particularly its upper regions. Researchers used this knowledge to examine climate models looking back in time for signs of these effects. The findings surprised lead author Ben Santer and co-author Susan Solomon, who did not expect to find such a clear human signal in the upper atmosphere so early in the climate record. 'It was surprising, really surprising to me the answer that we could have identified with high confidence a human-caused stratospheric cooling signal within 25 years of the start of monitoring, if we had back then in 1860 the measuring capability that we have today,' Santer, of the Woods Hole Oceanographic Institution, said. The signal of climate change was detectable in the 19th-century atmosphere after just a 10 parts per million increase in carbon dioxide concentrations in the 40 years between 1860 and 1899. For comparison, planet-warming carbon dioxide levels skyrocketed by about 50 parts per million between 2000 and 2025, Santer said. Overall, carbon dioxide levels in the atmosphere have increased by about 140 parts per million since the initially detectible point the scientists pinpointed. 'The results show it would have been detectable very quickly,' said Gabi Hegerl of the University of Edinburgh, who was not involved with the new paper. 'This highlights the strong influence that greenhouse gas increases have on the upper atmosphere compared to the variability there.' Andrea Steiner, a climate scientist at the Wegener Center for Climate and Global Change at the University of Graz in Austria, told CNN the study shows human-caused climate change can be detected earlier in the atmosphere than at the surface. 'This confirms that temperature change signals of the atmosphere are effective not only for detection, but also as early indicators of the success of climate mitigation efforts,' she said. Steiner was not involved in the new study. Both Santer and Solomon emphasized the results show the importance of continuing to closely monitor the upper atmosphere. That message comes at a time of steep scientific budget cuts, when crucial climate satellites and research programs are being targeted. This is particularly the case in the NOAA, NASA and Department of Energy budget proposals, Santer noted. The NOAA budget proposal, for example, would eliminate the air and oceans agency's research division, which includes carbon dioxide monitoring functions. In addition, the Trump administration's NASA budget proposal would cut some climate-relevant satellite missions, while stripping future NOAA satellites of climate science sensors. 'I do think it's important for non-scientists to know what's at stake here. That when we lose the capability to measure and monitor how our world is changing, it makes us all less safe,' Santer said.
CNN
38 minutes ago
- CNN
Fingerprint of human-caused global warming was likely detectable 140 years ago, far earlier than previously thought
The human fingerprint on global warming was likely evident in Earth's atmosphere far earlier than previously thought—even before the invention of modern cars, a new study says. Using a combination of scientific theory, modern observations and multiple, sophisticated computer models, researchers found a clear signal of human-caused climate change was likely discernible with high confidence as early as 1885, just before the advent of gas-powered cars but after the dawn of the industrial revolution. The findings, detailed in a paper published Monday in the journal Proceedings of the National Academy of Sciences, raise the likelihood that humanity has been remaking the planet's climate in a detectable way for longer than previously believed—and highlight the importance of tracking changes in the upper atmosphere. Scientists had begun to record surface temperature observations by the mid-19th century. The start date for a detectable human signal in surface temperatures has generally been thought to be in the early-to-mid-20th century, though other parts of the climate system showed signs of change at different times. For this study, the veteran climate researchers posed the question: With the observational tools of today, when is the earliest that the signs of human-caused climate change would have been detectable in the atmosphere? The study looked specifically at signals in the stratosphere – the second level of the atmosphere. Most weather occurs in the lowest level, the troposphere. While greenhouse gas emissions warm the lower atmosphere, they exert the opposite effect on the stratosphere, particularly its upper regions. Researchers used this knowledge to examine climate models looking back in time for signs of these effects. The findings surprised lead author Ben Santer and co-author Susan Solomon, who did not expect to find such a clear human signal in the upper atmosphere so early in the climate record. 'It was surprising, really surprising to me the answer that we could have identified with high confidence a human-caused stratospheric cooling signal within 25 years of the start of monitoring, if we had back then in 1860 the measuring capability that we have today,' Santer, of the Woods Hole Oceanographic Institution, said. The signal of climate change was detectable in the 19th-century atmosphere after just a 10 parts per million increase in carbon dioxide concentrations in the 40 years between 1860 and 1899. For comparison, planet-warming carbon dioxide levels skyrocketed by about 50 parts per million between 2000 and 2025, Santer said. Overall, carbon dioxide levels in the atmosphere have increased by about 140 parts per million since the initially detectible point the scientists pinpointed. 'The results show it would have been detectable very quickly,' said Gabi Hegerl of the University of Edinburgh, who was not involved with the new paper. 'This highlights the strong influence that greenhouse gas increases have on the upper atmosphere compared to the variability there.' Andrea Steiner, a climate scientist at the Wegener Center for Climate and Global Change at the University of Graz in Austria, told CNN the study shows human-caused climate change can be detected earlier in the atmosphere than at the surface. 'This confirms that temperature change signals of the atmosphere are effective not only for detection, but also as early indicators of the success of climate mitigation efforts,' she said. Steiner was not involved in the new study. Both Santer and Solomon emphasized the results show the importance of continuing to closely monitor the upper atmosphere. That message comes at a time of steep scientific budget cuts, when crucial climate satellites and research programs are being targeted. This is particularly the case in the NOAA, NASA and Department of Energy budget proposals, Santer noted. The NOAA budget proposal, for example, would eliminate the air and oceans agency's research division, which includes carbon dioxide monitoring functions. In addition, the Trump administration's NASA budget proposal would cut some climate-relevant satellite missions, while stripping future NOAA satellites of climate science sensors. 'I do think it's important for non-scientists to know what's at stake here. That when we lose the capability to measure and monitor how our world is changing, it makes us all less safe,' Santer said.
Yahoo
3 hours ago
- Yahoo
Pulsar Fusion Confirms Expansion to U.S. with New Texas Office, Signs MOU with Thales Alenia Space, Unveils UK's Largest Space Testing Facility, and Releases New Mission Video to Titan
Sunbird Thruster Image Thales Alenia Space (TAS)-Image Pulsar Fusion & Thales Alenia Space (TAS)-Image LONDON and AUSTIN, Texas, June 16, 2025 (GLOBE NEWSWIRE) -- Pulsar Fusion, the UK-based fusion propulsion company behind the breakthrough Sunbird platform, today announced a series of major developments as it expands its global footprint, advances key partnerships, and showcases its vision for interplanetary travel. The company is opening a new U.S. office in Austin, Texas, positioning itself at the heart of the rapidly growing American space and innovation ecosystem. This strategic move supports Pulsar's increasing engagement with U.S.-based clients and investors. Pulsar UK has also signed a Memorandum of Understanding with Thales Alenia Space (TAS) in relation to Pulsar's 5kW MOONRANGER Hall-effect thrusters, which are being live test-fired. This signifies the latest indication of Pulsars broadening commercial appeal to Tier 1 aerospace primes. Meanwhile in Bletchley, England, Pulsar is preparing to pump down the first of its two newly built space-grade vacuum chambers, now officially the largest of their kind in the United Kingdom. These facilities will enable critical qualification and endurance testing for both Pulsar's Hall-effect thrusters and its next-generation Sunbird platform. As part of its public outreach and future mission planning, the company has also released its latest concept video, showcasing a Sunbird-powered mission to Saturn's moon Titan. The video illustrates how Pulsar's fusion systems could cut travel times dramatically, delivering critical payloads across the solar system faster and more efficiently than current propulsion methods allow. CEO Richard Dinan said: 'Nuclear fusion is the pinnacle of space propulsion technology. These reactors are uniquely suited for in-orbit use, and in many ways, it's more practical to use fusion for space propulsion than for energy on Earth. That said, we must pursue both and I believe we will ultimately succeed in both. The recent acceleration in AI capabilities is a true game-changer for fusion. These systems will help us manage ultra-hot plasmas with far greater precision, enabling reactors to become smaller, more intelligent, and vastly more practical. It's an incredibly exciting time to be building fusion systems' About Pulsar Fusion Ltd. Established in 2013 as Applied Fusion Systems, Pulsar Fusion develops hyper-fast space propulsion systems using nuclear fusion. Fusion offers the best alternative with sufficient exhaust speed and thrust to propel spacecraft beyond our solar system. In 2022 and 2023 Pulsar Fusion was awarded multiple funding rounds from the UK Space Agency to conduct research into nuclear electric propulsion and to expand their large HET development. Pulsar is creating an ecosystem of propulsion systems and services that advance the use of fusion as a near-limitless, clean energy source. For more information, visit Media Contact Danielle PerezFirecracker PRdanielle@ (888) 317-4687 ext. 705 A video accompanying this announcement is available athttps:// Photos accompanying this announcement are available athttps:// in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
