Gian Luca Erre1, Maria Luisa Cadoni2, Pierluigi Meloni2, Floriana Castagna2, Arduino Aleksander Mangoni3, Matteo Piga4, Giuseppe Passiu5, Ciriaco Carru6, Angelo Zinellu7, Gianpaolo Vidili8. 1. Dipartimento di Specialità Mediche, UOC Reumatologia, Azienda Ospedaliero-Universitaria, Viale San Pietro 8, 07100 Sassari, Italy. Electronic address: gianluca.erre@aousassari.it. 2. Università degli Studi di Sassari, Piazza Università 21, 07100 Sassari, Italy. 3. Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Flinders Drive, Bedford Park SA, 5042 Adelaide, Australia. Electronic address: arduino.mangoni@flinders.edu.au. 4. UOC Reumatologia, Università degli Studi di Cagliari, Azienda Ospedaliero-Universitaria, Cagliari, SS 554 km 4,500, 09042 Monserrato, Cagliari, Italy. Electronic address: matteopiga@unica.it. 5. Dipartimento di Specialità Mediche, UOC Reumatologia, Azienda Ospedaliero-Universitaria, Viale San Pietro 8, 07100 Sassari, Italy; Università degli Studi di Sassari, Piazza Università 21, 07100 Sassari, Italy. Electronic address: gpassiu@uniss.it. 6. Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, Viale San Pietro 6, 07100 Sassari, Italy. Electronic address: carru@uniss.it. 7. Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, Viale San Pietro 6, 07100 Sassari, Italy. Electronic address: azinellu@uniss.it. 8. Università degli Studi di Sassari, Piazza Università 21, 07100 Sassari, Italy; Dipartimento di Medicina, UOC Clinica Medica, Azienda Ospedaliero-Universitaria di Sassari, Viale San Pietro 8, 07100 Sassari, Italy. Electronic address: gianpaolovidili@uniss.it.
Abstract
OBJECTIVE: To explore the significance of the association between treatment with methotrexate (MTX) and liver stiffness in rheumatoid arthritis (RA) patients. METHODS: We enrolled 140 consecutive RA patients under MTX treatment (MTX-treated RA; mean treatment duration: 6.2 years; mean MTX cumulative dose: 4.67 g), 33 RA patients naive to MTX (MTX-naive RA) and 100 age and sex-matched healthy blood donors (HD). Liver stiffness was assessed by real time two-dimensional shear wave elastography, with values ≥7.1 Kilopascals (kPa) defining significant liver fibrosis. RESULTS: kPa values in HD (4.32 ± 0.7) were lower than that in MTX-naive RA (4.92 ± 0.8) and MTX-treated RA (4.85 ± 0.9, p < .0005 for trend). On the contrary, the difference in kPa between MTX-naive and MTX-treated RA was not significant (p = .89). Similarly, liver stiffness was not significantly different across strata of cumulative MTX dose (4.95 ± 0.7 kPa in MTX <1 g, 4.90 ± 1.1 kPa in MTX 1-3 g and 4.80 ± 0.9 in MTX >3 g, p = .610). Significant liver fibrosis was diagnosed in 4 patients in the MTX-treated RA (highest kPa value = 7.6; no liver function test abnormalities or clinical signs of hepatic failure) and in none in both the MTX-naive RA and HD groups (p = .145). CONCLUSION: Liver stiffness values, although within the normal range, are significantly higher in RA patients vs. controls, irrespective of MTX treatment. RA patients taking MTX do not have a higher prevalence of significant liver fibrosis when compared to MTX naive RA patients and the general population.
OBJECTIVE: To explore the significance of the association between treatment with methotrexate (MTX) and liver stiffness in rheumatoid arthritis (RA) patients. METHODS: We enrolled 140 consecutive RApatients under MTX treatment (MTX-treated RA; mean treatment duration: 6.2 years; mean MTX cumulative dose: 4.67 g), 33 RApatients naive to MTX (MTX-naive RA) and 100 age and sex-matched healthy blood donors (HD). Liver stiffness was assessed by real time two-dimensional shear wave elastography, with values ≥7.1 Kilopascals (kPa) defining significant liver fibrosis. RESULTS:kPa values in HD (4.32 ± 0.7) were lower than that in MTX-naive RA (4.92 ± 0.8) and MTX-treated RA (4.85 ± 0.9, p < .0005 for trend). On the contrary, the difference in kPa between MTX-naive and MTX-treated RA was not significant (p = .89). Similarly, liver stiffness was not significantly different across strata of cumulative MTX dose (4.95 ± 0.7 kPa in MTX <1 g, 4.90 ± 1.1 kPa in MTX 1-3 g and 4.80 ± 0.9 in MTX >3 g, p = .610). Significant liver fibrosis was diagnosed in 4 patients in the MTX-treated RA (highest kPa value = 7.6; no liver function test abnormalities or clinical signs of hepatic failure) and in none in both the MTX-naive RA and HD groups (p = .145). CONCLUSION:Liver stiffness values, although within the normal range, are significantly higher in RApatients vs. controls, irrespective of MTX treatment. RApatients taking MTX do not have a higher prevalence of significant liver fibrosis when compared to MTX naive RApatients and the general population.
Authors: Martin Feuchtenberger; Lisa Kraus; Axel Nigg; Hendrik Schulze-Koops; Arne Schäfer Journal: Rheumatol Int Date: 2021-02-20 Impact factor: 2.631
Authors: Marek Frankowski; Jerzy Świerkot; Marek Gomułkiewicz; Lucyna Korman; Marta Skoczyńska; Aleksandra Starba Journal: Rheumatol Int Date: 2021-12-06 Impact factor: 2.631