title: Evaluation of liver fibrosis by transient elastography in methotrexate treated patients.
abstract: OBJECTIVE
  Methotrexate (MTX) safety is questioned by the risk of inducing liver fibrosis (LF). As transient elastography (FibroScan®) is an effective non-invasive technique to evaluate LF, our aims were to assess LF in MTX-treated patients, to evaluate LF regarding treatment duration and cumulative dose, and to determine differences depending on the underlying disease.
  
  
  METHODS
  Prospective study including patients with rheumatoid arthritis, inflammatory bowel disease, and psoriasis treated with MTX. Hepatic stiffness was determined by FibroScan®. The LF cut-off values were established using METAVIR score.
  
  
  RESULTS
  Of 53 patients, 22 were men (41.5%), mean age was 55 (15) years, 17 (32%) had rheumatoid arthritis, 18 (34%) inflammatory bowel disease, and 18 (34%) psoriasis. Mean MTX cumulative dose was 1,805 (1,560) mg, and mean treatment duration was 178 weeks. Mean hepatic stiffness was 6.19 (2.43) KPa. In 49 patients (92.5%), absence/mild LF was found (F ≤ 2), and 4 patients (7.5%) had advanced LF (F ≥ 3). Treatment duration or cumulative doses of MTX were not associated with LF.
  
  
  CONCLUSIONS
  Regarding LF development, MTX therapy is safe. FibroScan® is useful for monitoring LF in MTX-treated patients.
authors: Servicio de Aparato Digestivo y Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Madrid, Spain.
authors: Almudena
authors: A
authors: Barbero-Villares
authors: Jorge
authors: J
authors: Mendoza
authors: María
authors: M
authors: Trapero-Marugan
authors: Isidoro
authors: I
authors: Gonzalez-Alvaro
authors: Esteban
authors: E
authors: Daudén
authors: Javier P
authors: JP
authors: Gisbert
authors: Ricardo
authors: R
authors: Moreno-Otero
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy; D056486:Chemical and Drug Induced Liver Injury / Q000150:complications / Q000000981:diagnostic imaging*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy; D008103:Liver Cirrhosis / Q000139:chemically induced / Q000150:complications / Q000000981:diagnostic imaging*; D016015:Logistic Models; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
chemical_list: D007166:Immunosuppressive Agents; D008727:Methotrexate