Using FibroScan to Assess for the Development of Liver Fibrosis in Patients With Arthritis on Methotrexate: A Single-center Experience

Q2 Medicine

The Journal of rheumatology. Supplement Pub Date : 2022-03-15 DOI:10.3899/jrheum.211281

Saman Darabian, J. Wade, J. Kur, S. Wade, E. C. Sayre, M. Badii

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引用次数: 5

Abstract

Objective. Methotrexate (MTX) is often the primary medication to treat various rheumatic diseases (RDs) because of its low cost and its demonstrated efficacy in controlling disease activity. However, a concern has been the potential for hepatic fibrosis associated with long-term MTX usage. This study investigated the association between cumulative MTX intake and development of liver fibrosis by utilizing noninvasive transient elastography (FibroScan). Methods. All patients with inflammatory arthritis treated with MTX were offered screening with FibroScan. A certified technician measured liver stiffness after patients adhered to a fast. Relevant clinical information was obtained by patient survey and medical records review. The population was divided into quartiles based on participants’ cumulative dosage of MTX. Results. Five hundred twenty patients with RD were included in this study. The prevalence of stages F3 or F4 liver fibrosis was 13.3% in the control group and 12.7% in the entire sample. Compared with subgroup 1 (control with cumulative MTX exposure of ≤ 499 mg), MTX subgroups 2 to 4 were not significantly correlated with higher FibroScan scores (P = 0.82, 0.59, and 0.18, respectively). In multivariable linear regression analysis, statistically significant factors for liver stiffness were BMI, waist circumference, male sex, and age. Conclusion. No significant correlation between the cumulative MTX dosage and liver stiffness, even at high MTX doses, was observed. The analyses showed significant correlations between the FibroScan score and BMI. These findings were reassuring in that current rheumatology practice appears to be safe and effective in screening for liver fibrosis in patients on long-term low-dose MTX therapy.

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使用纤维扫描评估甲氨蝶呤关节炎患者肝纤维化的发展:单中心经验

目标。甲氨蝶呤(MTX)通常是治疗各种风湿性疾病(rd)的主要药物，因为它的成本低，并且在控制疾病活动方面具有明显的疗效。然而，一个值得关注的问题是长期使用甲氨蝶呤可能导致肝纤维化。本研究通过无创瞬时弹性成像(FibroScan)研究了累积MTX摄入量与肝纤维化发展之间的关系。方法。所有接受MTX治疗的炎性关节炎患者均接受纤维扫描筛查。一位持证技术员在病人坚持禁食后测量了他们的肝脏硬度。通过患者调查和病历查阅获得相关临床资料。根据参与者的甲氨蝶呤累积剂量将人群分为四分位数。结果。这项研究纳入了520名RD患者。F3或F4期肝纤维化的患病率在对照组为13.3%，在整个样本中为12.7%。与亚组1(累积MTX暴露≤499 mg的对照组)相比，MTX亚组2至4与较高的FibroScan评分无显著相关(P分别= 0.82、0.59和0.18)。在多变量线性回归分析中，影响肝硬度的因素有BMI、腰围、男性性别和年龄。结论。即使在高MTX剂量下，累积MTX剂量与肝脏硬度之间也未观察到显著相关性。分析显示，FibroScan评分与BMI之间存在显著相关性。这些发现令人放心，因为目前的风湿病学实践在长期低剂量MTX治疗的患者中筛查肝纤维化似乎是安全有效的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Journal of rheumatology. Supplement Medicine-Medicine (all)

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期刊介绍： The Journal of Rheumatology is a monthly international serial edited by Duncan A. Gordon, The Journal features research articles on clinical subjects from scientists working in rheumatology and related fields, as well as proceedings of meetings as supplements to regular issues. Highlights of our 36 years serving Rheumatology include: groundbreaking and provocative editorials such as "Inverting the Pyramid," renowned Pediatric Rheumatology, proceedings of OMERACT and the Canadian Rheumatology Association, Cochrane Musculoskeletal Reviews, and supplements on emerging therapies.