Medline ® Abstract for Reference 19
of 'Hepatotoxicity associated with chronic low-dose methotrexate for nonmalignant disease'
19
TI
Evaluation of liver fibrosis by transient elastography in methotrexate treated patients.
AU
Barbero-Villares A, Mendoza J, Trapero-Marugan M, Gonzalez-Alvaro I, Daudén E, Gisbert JP, Moreno-Otero R
SO
Med Clin (Barc). 2011 Nov;137(14):637-9. Epub 2011 Jun 29.
BACKGROUND AND AIMS:
Methotrexate (MTX) safety is questioned by the risk of inducing liver fibrosis (LF). As transient elastography (FibroScan®) is an effective non-invasive technique to evaluate LF, our aims were to assess LF in MTX-treated patients, to evaluate LF regarding treatment duration and cumulative dose, and to determine differences depending on the underlying disease.
PATIENTS AND METHODS:
Prospective study including patients with rheumatoid arthritis, inflammatory bowel disease, and psoriasis treated with MTX. Hepatic stiffness was determined by FibroScan®. The LF cut-off values were established using METAVIR score.
RESULTS:
Of 53 patients, 22 were men (41.5%), mean age was 55 (15) years, 17 (32%) had rheumatoid arthritis, 18 (34%) inflammatory bowel disease, and 18 (34%) psoriasis. Mean MTX cumulative dose was 1,805 (1,560) mg, and mean treatment duration was 178 weeks. Mean hepatic stiffness was 6.19 (2.43) KPa. In 49 patients (92.5%), absence/mild LF was found (F≤2), and 4 patients (7.5%) had advanced LF (F≥3). Treatment duration or cumulative doses of MTX were not associated with LF.
CONCLUSIONS:
Regarding LF development, MTX therapy is safe. FibroScan®is useful for monitoring LF in MTX-treated patients.
AD
Servicio de Aparato Digestivo y Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Madrid, Spain.
PMID