Methotrexate therapy is not associated with increased liver stiffness and significant liver fibrosis in rheumatoid arthritis patients: A cross-sectional controlled study with real-time two-dimensional shear wave elastography.
Eur J Intern Med
; 69: 57-63, 2019 Nov.
Article
em En
| MEDLINE
| ID: mdl-31474422
ABSTRACT
OBJECTIVE:
To explore the significance of the association between treatment with methotrexate (MTX) and liver stiffness in rheumatoid arthritis (RA) patients.METHODS:
We enrolled 140 consecutive RA patients under MTX treatment (MTX-treated RA; mean treatment duration 6.2â¯years; mean MTX cumulative dose 4.67â¯g), 33 RA patients naive to MTX (MTX-naive RA) and 100 age and sex-matched healthy blood donors (HD). Liver stiffness was assessed by real time two-dimensional shear wave elastography, with values ≥7.1 Kilopascals (kPa) defining significant liver fibrosis.RESULTS:
kPa values in HD (4.32⯱â¯0.7) were lower than that in MTX-naive RA (4.92⯱â¯0.8) and MTX-treated RA (4.85⯱â¯0.9, pâ¯<â¯.0005 for trend). On the contrary, the difference in kPa between MTX-naive and MTX-treated RA was not significant (pâ¯=â¯.89). Similarly, liver stiffness was not significantly different across strata of cumulative MTX dose (4.95⯱â¯0.7â¯kPa in MTX <1â¯g, 4.90⯱â¯1.1â¯kPa in MTX 1-3â¯g and 4.80⯱â¯0.9 in MTX >3â¯g, pâ¯=â¯.610). Significant liver fibrosis was diagnosed in 4 patients in the MTX-treated RA (highest kPa valueâ¯=â¯7.6; no liver function test abnormalities or clinical signs of hepatic failure) and in none in both the MTX-naive RA and HD groups (pâ¯=â¯.145).CONCLUSION:
Liver stiffness values, although within the normal range, are significantly higher in RA patients vs. controls, irrespective of MTX treatment. RA patients taking MTX do not have a higher prevalence of significant liver fibrosis when compared to MTX naive RA patients and the general population.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Metotrexato
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Antirreumáticos
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Técnicas de Imagem por Elasticidade
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Cirrose Hepática
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article