Methotrexate is not associated with increased liver cirrhosis in a population-based cohort of rheumatoid arthritis patients with chronic hepatitis C.
A few studies have shown that methotrexate (MTX) use exacerbates liver fibrosis and even leads to liver cirrhosis in rheumatoid arthritis (RA) patients, although the risk is low compared to psoriatics. We therefore conducted a population-based cohort study to investigate the impact of long-term MTX use on the risk of chronic hepatitis C (CHC)-related cirrhosis among RA patients. We analyzed data from the National Health Insurance Research Database in Taiwan and identified 450 incident cases of RA among CHC patients (255 MTX users and 195 MTX non-users) from January 1, 1998 to December 31, 2007. After a median follow-up of more than 5 years since the diagnosis of CHC, a total of 55 (12%) patients developed liver cirrhosis. We did not find an increased risk of liver cirrhosis among CHC patients with long-term MTX use for RA. Furthermore, there was no occurrence of liver cirrhosis among the 43 MTX users with a cumulative dose ≧3 grams after 108 months of treatment. In conclusion, our data showed that long-term MTX use is not associated with an increased risk for liver cirrhosis among RA patients with CHC. However, these results should be interpreted with caution due to potential bias in the cohort.
Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, R.O.C.|Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, R.O.C.
Kuo-Tung
KT
Tang
Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, R.O.C.|School of Medicine, National Yang-Ming University, Taipei, R.O.C.
Yi-Hsing
YH
Chen
Department of Medical Research, Taichung Veterans General Hospital, Taichung, R.O.C.
Ching-Heng
CH
Lin
Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, R.O.C.|School of Medicine, National Yang-Ming University, Taipei, R.O.C.|Institute of Microbiology and Immunology, Chung Shan Medical University, Taichung, R.O.C.|Institute of Biomedical Science, National Chung Hsing University, Taichung, R.O.C.
Der-Yuan
DY
Chen
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D012042:Registries
D008727:Methotrexate