Methotrexate, used for the treatment of rheumatoid arthritis and psoriasis, may also reduce the risk of atherosclerosis and circulatory diseases affecting the heart and brain, investigators have found.

As Dr. Robert S. Kirsner told AMN Health, “the finding that treatment of psoriasis - and rheumatoid arthritis - reduced the risk of development of vascular disease…suggests that patients with these diseases may derive benefit from treatment beyond control of their skin and joint disease.”

Kirsner, at the University of Miami, and colleagues note in the American Academy of Dermatology that methotrexate is an analogue of folate and has anti-inflammatory effects that may help reduce vascular disease. However, it may also promote higher levels of a compound called homocysteine, which can increase the risk of vascular disease.

To see how these two factors balance out in reality, the researchers studied data on 7615 outpatients with psoriasis and 6707 with rheumatoid arthritis who were treated at Veterans Administration facilities in Florida or Puerto Rico.

Those with psoriasis who were prescribed methotrexate had a significantly reduced risk of vascular disease compared with those who were not. The risk was lowest - at 50 percent - in those given a low dose of methotrexate. Similar but less pronounced risk reductions were seen in arthritis patients.

Despite its tendency to adversely affect homocysteine levels, methotrexate therapy “may provide further vasculoprotective benefits.” the researchers conclude.

SOURCE: American Academy of Dermatology, February 2005.