title: 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.
abstract: 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.
authors.affiliation: Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. m.berends@derma.umcn.nl
authors.forename: Maartje A M
authors.initials: MA
authors.lastname: Berends
authors.forename: Josje
authors.initials: J
authors.lastname: Snoek
authors.forename: Elke M G J
authors.initials: EM
authors.lastname: de Jong
authors.forename: J Han
authors.initials: JH
authors.lastname: Van Krieken
authors.forename: Robert J
authors.initials: RJ
authors.lastname: de Knegt
authors.forename: Martijn G H
authors.initials: MG
authors.lastname: van Oijen
authors.forename: Peter C M
authors.initials: PC
authors.lastname: van de Kerkhof
authors.forename: Joost P H
authors.initials: JP
authors.lastname: Drenth
mesh_terms: 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
chemical_list: D003879:Dermatologic Agents; D008727:Methotrexate