Biochemical and biophysical assessment of MTX-induced liver fibrosis in psoriasis patients: Fibrotest predicts the presence and Fibroscan predicts the absence of significant liver fibrosis.
BACKGROUND
Methotrexate (MTX) use is associated with hepatic fibrosis in psoriasis patients. To monitor this serial liver biopsies were performed. The Fibroscan and the Fibrotest are two novel, non-invasive methods that might be able to assess MTX-induced hepatic fibrosis.


OBJECTIVE
Evaluating the accuracy and feasibility of the Fibroscan and Fibrotest to detect significant MTX-induced liver fibrosis in psoriasis patients.


METHODS
We assessed 24 psoriasis patients who had a recent liver biopsy during MTX use. The results from the Fibroscan and Fibrotest were compared with liver histology.


RESULTS
Fibroscan values (n=20) ranged between 3.3 and 18.4 kPa (median value 6.4 kPa) and correctly identified 88% of the patients without significant liver fibrosis (Metavir score <F2, Fibroscan</=7.1 kPa). The Fibrotest identified 83% of the patients with significant liver fibrosis (Metavir score >/=F2, Fibrotest >0.31).


CONCLUSIONS
In this population, Fibrotest accurately predicted the presence of significant liver fibrosis while the Fibroscan accurately predicted the absence of significant liver fibrosis in MTX users. This suggests that a combination of Fibrotest and Fibroscan should prospectively be evaluated in monitoring and detecting significant MTX-induced liver fibrosis in psoriasis patients.
Berends
Maartje A M
MA
Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. m.berends@derma.umcn.nl
Snoek
Josje
J
de Jong
Elke M G J
EM
Van Krieken
J Han
JH
de Knegt
Robert J
RJ
van Oijen
Martijn G H
MG
van de Kerkhof
Peter C M
PC
Drenth
Joost P H
JP
D000328:Adult; D000368:Aged; D000465:Algorithms; D001185:Artificial Intelligence; D001706:Biopsy; D003879:Dermatologic Agents / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008103:Liver Cirrhosis / Q000139:chemically induced / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008727:Methotrexate / Q000009:adverse effects*; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D014463:Ultrasonography
D003879:Dermatologic Agents; D008727:Methotrexate