Methotrexate for psoriasis and cutaneous melanoma study

[Fred]

This study suggests the use of Methotrexate for psoriasis was not associated with an enhanced risk for cutaneous malignant melanoma (CMM)

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Background:
Cutaneous malignant melanoma (CMM) is a highly immunogenic tumor. Patients with an impaired immune system have an enhanced risk for CMM and a worse prognosis. Methotrexate (MTX) is an anti‐inflammatory and immunosuppressive drug frequently used for treating patients with psoriasis. An association between MTX and risk of CMM has previously been demonstrated in patients with rheumatoid arthritis.

Objectives:
To investigate if MTX increases the risk of CMM among patients with psoriasis.

Methods:
A nested case‐control investigation from a Swedish cohort of psoriasis patients was conducted. Data were obtained from available Swedish registers and included 395 previously cancer‐free psoriasis patients with a first CMM in the time period January 1, 2010 to December 31, 2016. Ten randomly selected cancer‐free psoriasis patients were matched per case with respect to age (same birth year) and sex. The accumulated MTX‐doses in both groups was obtained. Crude odds ratios (ORs) for the proportion of MTX in the respective group using conditional logistic regression analyses was conducted.

Results:
Of 395 psoriasis patients with CMM, 97 (25%) had filled any prescription of MTX. Among 3950 controls, the corresponding number was 954 (24%). In a conditional logistic regression analysis, no association between MTX‐exposure (ever use) and risk for CMM were observed (OR 1.0 [95% CI, 0.8‐1.3]). Moreover, no indication of a dose‐response association was observed.

Conclusions:
In this Swedish nested case‐control study, the use of MTX was not associated with an enhanced risk for CMM. These findings are reassuring to dermatologists in everyday clinical practice.

Source: onlinelibrary.wiley.com

*Early view funding unknown