Sung-Hoon Park1, Jung-Yoon Choe, Seong-Kyu Kim. 1. Catholic university of Daegu, School of medicine, arthritis and autoimmunity research centre, Daegu, Republic of Korea.
Abstract
OBJECTIVE: This study was designed to assess the degree of liver fibrosis with transient elastography and noninvasive biochemical methods in rheumatoid arthritis patients treated with methotrexate. METHODS: We reviewed the medical records of rheumatoid arthritis patients who were administered methotrexate for more than 3 years. Transient elastography was performed and serological markers of liver fibrosis were evaluated by prospectively and was compared with the result of healthy control group. A correlation of the cumulative dose of methotrexate with the elastography value (kPa) or the level of serological markers was assessed. Two subgroups of patients were compared; patients who received a cumulative dose of methotrexate of less than 4000 mg (group 1) and more than 4000 mg (group 2). A total of 177 consecutive rheumatoid arthritis patients were evaluated. RESULTS: The mean cumulative dose of methotrexate was 3988 ± 1566 mg with doses ranging from 652.5 to 10,415 mg. The mean elastography value of all patients was 4.01 ± 0.77 kPa. The kilopascal values and levels of biochemical markers did not correlate with the cumulative dose of methotrexate, but did correlate with the AST to ALT ratio, AST to platelet ratio index, haptoglobin level. Mean kilopascal values were not statistically different for group 1 and group 2 patients. For rheumatoid arthritis patients treated with a high cumulative dose of methotrexate, significant liver fibrosis is rare and is not accurately detected in patients with liver enzyme abnormalities. CONCLUSION: Taking into account the risk and benefit of a liver biopsy, transient elastography can be recommended as an additional diagnostic option.
OBJECTIVE: This study was designed to assess the degree of liver fibrosis with transient elastography and noninvasive biochemical methods in rheumatoid arthritispatients treated with methotrexate. METHODS: We reviewed the medical records of rheumatoid arthritispatients who were administered methotrexate for more than 3 years. Transient elastography was performed and serological markers of liver fibrosis were evaluated by prospectively and was compared with the result of healthy control group. A correlation of the cumulative dose of methotrexate with the elastography value (kPa) or the level of serological markers was assessed. Two subgroups of patients were compared; patients who received a cumulative dose of methotrexate of less than 4000 mg (group 1) and more than 4000 mg (group 2). A total of 177 consecutive rheumatoid arthritispatients were evaluated. RESULTS: The mean cumulative dose of methotrexate was 3988 ± 1566 mg with doses ranging from 652.5 to 10,415 mg. The mean elastography value of all patients was 4.01 ± 0.77 kPa. The kilopascal values and levels of biochemical markers did not correlate with the cumulative dose of methotrexate, but did correlate with the AST to ALT ratio, AST to platelet ratio index, haptoglobin level. Mean kilopascal values were not statistically different for group 1 and group 2 patients. For rheumatoid arthritispatients treated with a high cumulative dose of methotrexate, significant liver fibrosis is rare and is not accurately detected in patients with liver enzyme abnormalities. CONCLUSION: Taking into account the risk and benefit of a liver biopsy, transient elastography can be recommended as an additional diagnostic option.
Authors: Deana D Hoganson; Jun Chen; Richard L Ehman; Jayant A Talwalkar; Clement J Michet; Meng Yin; Cynthia S Crowson; Eric L Matteson Journal: Open J Rheumatol Autoimmune Dis Date: 2012-05
Authors: Zhengyi Wang; Yi Huang; Hans Nossent; Jonathan J Chan; Leon A Adams; John Joseph; Wendy Cheng; George Garas; Gerry MacQuillan; Gary P Jeffrey Journal: JGH Open Date: 2020-10-21