Liver Fibrosis in Rheumatoid Arthritis Patients Treated with Methotrexate

Title:Liver Fibrosis in Rheumatoid Arthritis Patients Treated with Methotrexate

Volume: 16 Issue: 4

Author(s): Ghizlane Hilal*, Nessrine Akasbi , Hanae Boudouaya , Ksir Salma and Taoufik Harzy

Affiliation:

• Department of Rheumatology, CHU Hassan II, Fez,Morocco

Keywords: Methotrexate, rheumatoid arthritis, hepatic fibrosis, liver fibrosis, anti-TNF therapy, DMARDs.

Abstract:

Introduction: Methotrexate (MTX) is a highly effective therapy for patients with rheumatoid arthritis (RA). However, it has been associated with a range of liver related adverse events. The aim of our study was to evaluate the prevalence rate of liver fibrosis in RA patients and to assess the correlation of cumulative MTX dose with hepatic fibrosis in our context.

Materials and Methods: This is a cross-sectional study, whose goal is to describe and analyze the factors correlated with the liver fibrosis in RA patients treated with methotrexate especially the cumulative dose of MTX, along the period lying between January 2012 and March 2019. The study was carried out in the Rheumatology Department of the University Hospital Hassan II of Fez. The patients have met the assessment of the ACR 2010 criteria. The data was recorded and analyzed using SPSS v20 univariate and bivariate analysis. A value of p <0.05 has been used to identify factors associated with liver fibrosis.

Results: A total of 319 patients with RA were recruited who were on MTX treatment. There were 276 female and 43 male patients (female: male ratio of 6.3). The average age was 53 years + /-12.4 years. The average duration of symptoms was 10.68 +/-6.9 years. RA was seropositive for the rheumatoid factor or the anti-ccp in 90.3 %. Six patients (2%) had developed liver fibrosis while on MTX therapy.

In the bivariate analysis, the liver fibrosis is significantly related to the hepatic cytolysis (p<0.001) and to the combination of MTX with other DMARDs (p<0.05). However, the multiple logistic regression analysis did not find any significant association between the groups.

Conclusion: In our context, the prevalence rate of hepatic fibrosis in patients with rheumatoid arthritis under methotrexate is low. It is seen much more in patients treated with methotrexate in combination with other disease-modifying anti-rheumatic drugs (DMARDs). These results require confirmation in a larger number of patients.

Cite this article as:

Hilal Ghizlane *, Akasbi Nessrine , Boudouaya Hanae , Salma Ksir and Harzy Taoufik , Liver Fibrosis in Rheumatoid Arthritis Patients Treated with Methotrexate, Current Rheumatology Reviews 2020; 16 (4) . https://dx.doi.org/10.2174/1573397116666200319155247

DOI https://dx.doi.org/10.2174/1573397116666200319155247	Print ISSN 1573-3971
Publisher Name Bentham Science Publisher	Online ISSN 1875-6360