Sparks JA, Vanni KMM, Sparks MA, et al. - In patients with normal kidney function or mild-to-moderate CKD at baseline, the kidney safety of low-dose methotrexate (LD-MTX) was evident in this study.

• In this secondary analysis using the randomized double-blind, placebo-controlled Cardiovascular Inflammation Reduction Trial, adults with cardiovascular disease and diabetes and/or metabolic syndrome were included (2,391 were randomized to LD-MTX and 2,395 to placebo).

• Less reduction in eGFR was observed with LD-MTX vs placebo (difference in least-squares mean ΔeGFR from baseline to on-treatment visits: 0.93 ml/min per 1.73 m ², 95% confidence interval [95% CI], 0.45 to 1.40, P<0.001).

• In the LD-MTX and placebo groups, there occurred 138 (incidence rate [IR], 2.97 per 100 person-years) and 184 (IR, 3.99 per 100 person-years) kidney adverse events, respectively, (hazard ratio: 0.73) during safety laboratory monitoring.