Tatjana Zekić, Filip Blažić, Nataša Katalinić, Nada Starčević Čizmarević, Aleksandar Čubranić
{"title":"Methotrexate and biological therapy are not associated with fatty liver in rheumatoid arthritis-a cross-sectional study.","authors":"Tatjana Zekić, Filip Blažić, Nataša Katalinić, Nada Starčević Čizmarević, Aleksandar Čubranić","doi":"10.1007/s00296-025-05987-0","DOIUrl":null,"url":null,"abstract":"<p><p>The prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with rheumatoid arthritis (RA) is approximately 30%. The relationship between conventional synthetic and biologic disease-modifying antirheumatic drugs (csMDARDs and bDMARDs) and NAFLD is complex and requires careful consideration in clinical practice. This study evaluates the impact of various treatment regimens and analyzes the relationship between NAFLD, defined by a controlled attenuation parameter (CAP) threshold of 275 dB/m, and liver fibrosis (liver stiffness measurement > 8 kPa) and clinical parameters in 170 RA patients. Treatment groups were categorized based on methotrexate (MTX) use (\"YES\" and \"NO\") and the use of biologic agents, including tumor necrosis factor inhibitors (TNFi), interleukin-6 (IL-6) inhibitors, as well as non-treatment groups. The prevalence of NAFLD in RA patients was found to be 36%, primarily attributed to components of metabolic syndrome and obesity including body-mass index (BMI), waist (WC) and hip circumference (HC), alanine aminotransferase (ALT), aspartate aminotransferase (AST) (all p < .001) triglycerides (p = .049). No significant differences in NAFLD prevalence were observed between treatment groups or between MTX treatment groups (cumulative doses < 3 g and > 3 g; p = 1.0). Furthermore, TNFi treatment duration did not show a significant correlation with NAFLD (Spearman's rho = 0.024, p = .897) or with fibrosis severity (Spearman's rho = 0.087, p = .640). In contrast, the duration of IL-6 inhibitor treatment demonstrated a significant negative correlation with NAFLD (Pearson's r=-0,41, p = .029). Methotrexate does not appear to influence NAFLD or fibrosis in RA patients. In contrast, long-term use of IL-6 receptor inhibitors may contribute to a reduction in NAFLD.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 10","pages":"236"},"PeriodicalIF":2.9000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rheumatology International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00296-025-05987-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
The prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with rheumatoid arthritis (RA) is approximately 30%. The relationship between conventional synthetic and biologic disease-modifying antirheumatic drugs (csMDARDs and bDMARDs) and NAFLD is complex and requires careful consideration in clinical practice. This study evaluates the impact of various treatment regimens and analyzes the relationship between NAFLD, defined by a controlled attenuation parameter (CAP) threshold of 275 dB/m, and liver fibrosis (liver stiffness measurement > 8 kPa) and clinical parameters in 170 RA patients. Treatment groups were categorized based on methotrexate (MTX) use ("YES" and "NO") and the use of biologic agents, including tumor necrosis factor inhibitors (TNFi), interleukin-6 (IL-6) inhibitors, as well as non-treatment groups. The prevalence of NAFLD in RA patients was found to be 36%, primarily attributed to components of metabolic syndrome and obesity including body-mass index (BMI), waist (WC) and hip circumference (HC), alanine aminotransferase (ALT), aspartate aminotransferase (AST) (all p < .001) triglycerides (p = .049). No significant differences in NAFLD prevalence were observed between treatment groups or between MTX treatment groups (cumulative doses < 3 g and > 3 g; p = 1.0). Furthermore, TNFi treatment duration did not show a significant correlation with NAFLD (Spearman's rho = 0.024, p = .897) or with fibrosis severity (Spearman's rho = 0.087, p = .640). In contrast, the duration of IL-6 inhibitor treatment demonstrated a significant negative correlation with NAFLD (Pearson's r=-0,41, p = .029). Methotrexate does not appear to influence NAFLD or fibrosis in RA patients. In contrast, long-term use of IL-6 receptor inhibitors may contribute to a reduction in NAFLD.
期刊介绍:
RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology.
RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.