Document Detail


Assessment of liver fibrosis with transient elastography and FibroTest in patients treated with methotrexate for chronic inflammatory diseases: a case-control study.
MedLine Citation:
PMID:  20801541     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Although methotrexate (MTX) is used in the effective treatment of inflammatory disorders, its use is hampered by the risk of liver fibrosis. Non-invasive methods for the diagnosis of liver fibrosis, such as transient elastography (FibroScan) and FibroTest could be useful for monitoring MTX-liver toxicity. The aim of this case-control study was to determine factors associated with liver fibrosis in a large cohort of patients requiring MTX.
METHODS: Consecutive adults with various benign inflammatory diseases were prospectively assessed using FibroScan and FibroTest when they were treated with MTX (cases) or before beginning treatment (controls).
RESULTS: Among 518 included patients, 44 patients (8.5%) had FibroScan and/or FibroTest results suggesting severe liver fibrosis. In a multivariate analysis, factors associated with abnormal markers of liver fibrosis were the body mass index >28 kg/m(2) and high alcohol consumption. Neither long MTX duration nor cumulative doses were associated with elevated FibroScan or FibroTest results.
CONCLUSIONS: Severe liver fibrosis is a rare event in patients treated with MTX and is probably unrelated to the total dose. Patients with other risk factors for liver disease should be closely monitored with non-invasive methods before and during MTX treatment.
Authors:
David Laharie; Julien Seneschal; Thierry Schaeverbeke; Marie-Sylvie Doutre; Maïté Longy-Boursier; Jean-Luc Pellegrin; Edouard Chabrun; Sandrine Villars; Frank Zerbib; Victor de Lédinghen
Publication Detail:
Type:  Journal Article     Date:  2010-08-12
Journal Detail:
Title:  Journal of hepatology     Volume:  53     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2011-02-24     Revised Date:  2012-08-24    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1035-40     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Affiliation:
Inserm U853, Univ Bordeaux 2, Bordeaux F-33076, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Alanine Transaminase / blood
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage,  adverse effects*
Aspartate Aminotransferases / blood
Biological Markers / blood
Biopsy
Case-Control Studies
Elasticity Imaging Techniques / methods*
Female
Humans
Inflammation / drug therapy*
Liver Cirrhosis / blood,  chemically induced,  diagnosis*
Liver Function Tests / methods
Male
Methotrexate / administration & dosage,  adverse effects*
Middle Aged
Prospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Biological Markers; 59-05-2/Methotrexate; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase

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