Methotrexate, Blood Pressure and Arterial Function in Rheumatoid Arthritis

Korábbi kezelés

• Participation in a clinical trial within 3 months prior to the start of the study.
• Resistant hypertension: clinical blood pressure ≥140/90 mm Hg despite concurrent use of three antihypertensive agents of different classes, one of which is a diuretic.
• Treatment with nitrates.
• Glomerulonephritis treated with or likely to be treated with immunosuppressant drugs
• Clinical diagnosis of dementia, treatment with medications for dementia or, in the opinion of the study staff, the participant is cognitively unable to follow the protocol.
• Any organ transplant.

Más betegség

• Secondary causes of hypertension.
• Grade 2 (moderate) or 3 (severe) hypertension: clinic blood pressure >160/100 mm Hg.
• Clinical systolic blood pressure <100 mm Hg or history of symptomatic orthostatic hypotension.
• Cardiovascular event, procedure, or hospitalization for unstable angina with the last 6 months.
• Heart failure.
• Diagnosis of polycystic kidney disease.
• Other medical, psychiatric, or behavioural factors that in the judgment of the study staff may interfere with study participation.
• Cancer diagnosed and treated within the past 2 years that, in the judgment of the study staff, would compromise a participant's ability to comply with the protocol and complete the study.
• Significant illness within 2 weeks of study start.
• Patients with an unstable active medical condition that could impair evaluation of study results.

Laborértékek

• Estimated glomerular filtration rate (eGFR) <45 mL/min.
• Uncontrolled diabetes with HbA1c >9.0% (>75 mmol/mol).
• Uncontrolled dyslipidaemia with total serum cholesterol >7.5 mmol/L or triglycerides >5.6 mmol/L.

Egyéb

• Contraindication to MTX or sulfasalazine.
• Patient who cannot be followed during 6 months.
• Active alcohol or substance abuse within the last 12 months.
• Body mass index >35 Kg/m2.
• Atrial fibrillation.
• Pregnancy, currently trying to become pregnant, or of child bearing potential and not using birth control.

• Patient with rheumatoid arthritis according to EULAR/ACR 2010 criteria.
• Age ≥18 years.
• Written informed consent, dated and signed before initiating any study-related procedure.