A pragmatic non-invasive assessment of liver fibrosis in patients with psoriasis, rheumatoid arthritis or Crohn's disease receiving methotrexate therapy - 16/02/21
, Blandine Alby-Lepresle a, Delphine Weil a, Peng Zhong a, François Aubin c, Daniel Wendling d, Eric Toussirot b, d, Lucine Vuitton e, Franck Carbonnel e, Raphaële Blondet b, Thierry Thévenot a, Paul Calès f, Elisabeth Monnet a, b, Vincent Di Martino aBenvenuto su EM|consulte, il riferimento dei professionisti della salute.
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Highlights |
• | What is already known about this subject?
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• | What this study adds?
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Summary |
Background and aims |
The reported hepatotoxicity of methotrexate underlines the need for a repeated non-invasive and reliable evaluation of liver fibrosis. We estimated, using a non-invasive strategy, the prevalence of significant liver fibrosis in patients treated by methotrexate and the predictors of significant fibrosis (fibrosis≥F2).
Methods |
Fibrosis was prospectively evaluated using 9 non-invasive tests in consecutive patients with psoriasis, rheumatoid arthritis, or Crohn's disease. Significant fibrosis was assessed without liver biopsy by defining a “specific method” (result given by the majority of the tests) and a “sensitive method” (at least one test indicating a stage≥F2).
Results |
One hundred and thirty-one patients (66 Psoriasis, 40 rheumatoid arthritis, and 25 Crohn's disease) were enrolled, including 83 receiving methotrexate. Seven tests were performed on average per patient, with a complete concordance in 75% of cases. Fibroscan® was interpretable in only 61% of patients. The best performances (AUROC>0.9) for predicting significant fibrosis were obtained by tests dedicated to steatohepatitis (FibroMeter NAFLD, NFS and FPI). The prevalence of fibrosis≥F2 according to the “specific” or the “sensitive” assessment of fibrosis was 10% and 28%, respectively. Methotrexate exposure did not influence the fibrosis stage. Factors independently associated with significant fibrosis according our “sensitive method” were age, male gender, and metabolic syndrome.
Conclusion |
We provided a non-invasive approach for identifying liver fibrosis≥F2 by using 8 biochemical tests and Fibroscan®. In this population, the risk of significant fibrosis was related to age, male gender, and presence of metabolic syndrome, but was not influenced by methotrexate.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Methotrexate, Liver fibrosis, Non-invasive fibrosis marker, Transient elastography, Psoriasis, Crohn's disease, Rheumatoid arthritis, Metabolic syndrome, Non-alcoholic steatohepatitis
Mappa
| ☆ | Data availability statement: the data that support the findings of this study are available from the corresponding author upon request. |
| ☆☆ | This article was originally published in Clinics and Research in Hepatology and Gastroenterology: X. Clinics and Research in Hepatology and Gastroenterology: X is now discontinued and the article is reprinted here for the reader's convenience. For citation purposes, please use the publication details of this article; Clinics and Research in Hepatology and Gastroenterology, 44S. |
Vol 44 - N° S
Articolo 100003- Gennaio 2020 Ritorno al numero
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