Evaluation of liver fibrosis by transient elastography in methotrexate treated patients

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• 作者：Almudena Barbero-Villares^a ; Jorge Mendoza^a ; Marí ; a Trapero-Marugan^a ; Isidoro Gonzalez-Alvaro^b ; Esteban Daudé ; n^c ; Javier P. Gisbert^a ; Ricardo Moreno-Otero^a ; ^{rmoreno.hlpr@salud.madrid.org}
• 关键词：Transient elastography ; FibroScan® ; Liver fibrosis ; Methotrexate ; Rheumatoid arthritis ; Inflammatory bowel disease ; Psoriasis
• 刊名：Medicina Cl铆nica
• 出版年：2011
• 期刊代码：pca254_00257753
• 类别：med
• 出版时间：26 November 2011
• 卷：137
• 期：14
• 页码：637-639
• 文件大小：193 K

摘要

<h4 class="h4">Background and aimsh4>Methotrexate (MTX) safety is questioned by the risk of inducing liver fibrosis (LF). As transient elastography (FibroScan^庐) 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.<h4 class="h4">Patients and methodsh4>

Prospective study including patients with rheumatoid arthritis, inflammatory bowel disease, and psoriasis treated with MTX. Hepatic stiffness was determined by FibroScan^庐. The LF cut-off values were established using METAVIR score.<h4 class="h4">Resultsh4>

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 鈮?2), and 4 patients (7.5%) had advanced LF (F 鈮?3). Treatment duration or cumulative doses of MTX were not associated with LF.<h4 class="h4">Conclusionsh4>

Regarding LF development, MTX therapy is safe. FibroScan^庐 is useful for monitoring LF in MTX-treated patients.