Medline ® Abstract for Reference 20
of 'Hepatotoxicity associated with chronic low-dose methotrexate for nonmalignant disease'
20
TI
Assessment of liver fibrosis with transient elastography and FibroTest in patients treated with methotrexate for chronic inflammatory diseases: a case-control study.
AU
Laharie D, Seneschal J, Schaeverbeke T, Doutre MS, Longy-Boursier M, Pellegrin JL, Chabrun E, Villars S, Zerbib F, de Lédinghen V
SO
J Hepatol. 2010 Dec;53(6):1035-40. Epub 2010 Aug 12.
BACKGROUND&AIMS:
Although methotrexate (MTX) is used in the effective treatment of inflammatory disorders, its use is hampered by the risk of liver fibrosis. Non-invasive methods for the diagnosis of liver fibrosis, such as transient elastography (FibroScan) and FibroTest could be useful for monitoring MTX-liver toxicity. The aim of this case-control study was to determine factors associated with liver fibrosis in a large cohort of patients requiring MTX.
METHODS:
Consecutive adults with various benign inflammatory diseases were prospectively assessed using FibroScan and FibroTest when they were treated with MTX (cases) or before beginning treatment (controls).
RESULTS:
Among 518 included patients, 44 patients (8.5%) had FibroScan and/or FibroTest results suggesting severe liver fibrosis. In a multivariate analysis, factors associated with abnormal markers of liver fibrosis were the body mass index>28 kg/m(2) and high alcohol consumption. Neither long MTX duration nor cumulative doseswere associated with elevated FibroScan or FibroTest results.
CONCLUSIONS:
Severe liver fibrosis is a rare event in patients treated with MTX and is probably unrelated to the total dose. Patients with other risk factors for liver disease should be closely monitored with non-invasive methods before and during MTX treatment.
AD
Inserm U853, Univ Bordeaux 2, Bordeaux F-33076, France.
PMID