Liver Stiffness by Transient Elastography (FibroScan®) in Rheumatoid Arthritis Patients Treated with Methotrexate

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Pinyok Srisansanee
Tithivalan Wangsuddee


Background: The association between liver fibrosis, assessed by transient elastography (TE), and methotrexate (MTX) treatment in patient with rheumatoid arthritis (RA) is not clear. Aims of this study were to assess the degree of liver stiffness with TE and to determine factors associated with liver fibrosis in patients receiving MTX.
Methods: We conducted a cross-sectional study in adult RA patients who were administrated MTX for more than 3 years. Transient elastography was performed. Significant liver fibrosis was defined as liver stiffness measurement (LSM) value ≥ 7 kPa. Associated factors were tested by logistic regression analysis.
Results: Among 264 rheumatoid arthritis included patients, 57 patients (21.6%) had significant liver fibrosis. The mean LSM value was 5.9±2.2 kPa. The mean cumulative dose of MTX was 3,640.7±1,452.0 mg. The mean duration of MTX usage was 6.4±2.8 years. Neither cumulative MTX doses nor MTX duration usage was correlated with liver stiffness measurement.
Conclusion: MTX induced liver fibrosis is uncommon in RA patients who had no underlying liver disease or predisposing factors for liver damage. Cumulative dose and duration of MTX requiring are probably unrelated to liver fibrosis.
Keywords: liver stiffness, liver fibrosis, transient elastgraphy, rheumatoid arthritis, methotrexate


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