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- Title
Higher Vitamin D Levels before Methotrexate Therapy Initiation Are Associated with Lower Subsequent Mortality in Patients with Rheumatoid Arthritis.
- Authors
Malakooti, Shahdi K.; Siddiqui, Hinnah; Wilson, Brigid; Bej, Taissa; O'Mara, Megan; Desotelle, Alexandra; Lange, Alyssa; Shive, Carey L.; Singer, Nora G.; McComsey, Grace A.; Kostadinova, Lenche; Mattar, Maya; Zidar, David A.; Anthony, Donald D.
- Abstract
(1) Vitamin D deficiency is associated with mortality in the general population and has been observed in one rheumatoid arthritis (RA) cohort. Here, we investigate the relationship between 25-hydroxyvitamin D (25(OH)D) levels before methotrexate (MTX) therapy initiation in patients with RA and the subsequent all-cause mortality in a national Veterans Affairs (VA) cohort. (2) This is a retrospective study on RA patients time-oriented around the initial MTX prescription and 25(OH)D levels before starting MTX. We examined survival in patients with 25(OH)D levels > 50 nmol/L and ≤50 nmol/L using the Cox Proportional Hazard Model and fully adjusted for risk factors. (3) In total, 15,109 RA patients were included in the nationwide cohort. RA patients with 25(OH)D levels > 50 nmol/L before starting MTX had a 28% reduced risk of mortality when compared to those with levels ≤ 50 nmol/L (HR: 0.72, CI: 0.64–0.80, p < 0.001) after adjusting for traditional risk factors. (4) In this national RA cohort receiving standard-of-care MTX, patients with 25(OH)D levels > 50 nmol/L have a lower subsequent mortality when compared to those with 25(OH)D levels ≤ 50 nmol/L. It remains to be determined whether increasing Vitamin D levels in RA patients initially found to be Vitamin D deficient impacts their all-cause mortality.
- Subjects
CAUSES of death; SURVIVAL; CONFIDENCE intervals; RETROSPECTIVE studies; METHOTREXATE; VITAMIN D; PSYCHOLOGY of veterans; RISK assessment; COMPARATIVE studies; RHEUMATOID arthritis; DESCRIPTIVE statistics; RESEARCH funding; ODDS ratio; PROPORTIONAL hazards models; LONGITUDINAL method
- Publication
Nutrients, 2024, Vol 16, Issue 3, p401
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu16030401