The relationship between dose of methotrexate and incidence of liver fibrosis in patients with rheumatoid arthritis
Introduction Methotrexate (MTX) is a chemotherapy agent and immune system suppressant that can cause liver fibrosis in long-term usage. This study aimed to investigate the relationship between the dose of MTX and the incidence of liver fibrosis in patients with rheumatoid arthritis (RA). Material a...
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| Format: | Article |
| Language: | English |
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Termedia Publishing House
2025-02-01
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| Series: | Rheumatology |
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| Online Access: | https://reu.termedia.pl/The-relationship-between-dose-of-methotrexate-and-incidence-of-liver-fibrosis-in,199740,0,2.html |
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| author | Mina AkbariRad Zahra Rezaieyazdi Ali Tajik Banafshe Ataei Mehrdad Sarabi Hasan MehradMajd Hasan Vossoughinia Abdollah Firoozi |
| author_facet | Mina AkbariRad Zahra Rezaieyazdi Ali Tajik Banafshe Ataei Mehrdad Sarabi Hasan MehradMajd Hasan Vossoughinia Abdollah Firoozi |
| author_sort | Mina AkbariRad |
| collection | DOAJ |
| description | Introduction
Methotrexate (MTX) is a chemotherapy agent and immune system suppressant that can cause liver fibrosis in long-term usage. This study aimed to investigate the relationship between the dose of MTX and the incidence of liver fibrosis in patients with rheumatoid arthritis (RA).
Material and methods
This cohort study was conducted on RA patients with normal liver function who took MTX. Liver FibroScan and laboratory tests, including α 2 -macroglobulin, total bilirubin, g-glutamyltransferase, apolipoprotein A1, haptoglobin, and alanine transaminase was performed. The patients were divided into 2 groups regarding their cumulative dose of MTX and the rate of liver fibrosis incidence was compared between the 2 groups.
Results
In total, 60 RA patients with the mean age of 55.2 ±11.8 years were enrolled. The mean duration of MTX use in patients was 6.9 ±3.8 years, and it was higher in the higher cumulative dose MTX group (> 2 g) than in the lower cumulative dose group (< 2 g; p < 0.0001). The overall prevalence of grade 3 fibrosis was 3.33%. The prevalence of second- and third-degree liver fibrosis in patients receiving a lower cumulative dose was respectively 9 (28.1%) and 1 (3.1%), and in patients receiving a higher cumulative dose it was 7 (25%) and 1 (3.6%), respectively. There was no statistically significant difference between the 2 groups regarding the prevalence of liver fibrosis ( p = 0.88). Both aspartate aminotransferase to platelet ratio index and Fibrosis Index Based on 4 Factors indices showed no significant difference between the 2 groups ( p = 0.594, p = 0.232).
Conclusions
These results suggest that long-term treatment with a higher cumulative dose of MTX is not associated with a higher incidence of liver fibrosis in RA patients. |
| format | Article |
| id | doaj-art-cf99c5c02d064eb7aa109c060a8ea9d3 |
| institution | OA Journals |
| issn | 0034-6233 2084-9834 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Rheumatology |
| spelling | doaj-art-cf99c5c02d064eb7aa109c060a8ea9d32025-08-20T02:24:54ZengTermedia Publishing HouseRheumatology0034-62332084-98342025-02-0163131110.5114/reum/199740199740The relationship between dose of methotrexate and incidence of liver fibrosis in patients with rheumatoid arthritisMina AkbariRad0https://orcid.org/0000-0002-1071-7983Zahra Rezaieyazdi1Ali Tajik2https://orcid.org/0000-0001-5976-7319Banafshe Ataei3Mehrdad Sarabi4Hasan MehradMajd5Hasan Vossoughinia6Abdollah Firoozi7https://orcid.org/0000-0002-3048-5139Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, IranRheumatic Disease Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, IranStudent Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, IranDepartment of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, IranStudent Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, IranClinical Research Unit, Mashhad University of Medical Sciences, IranDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, IranFaculty of Pharmacy, Mashhad University of Medical Sciences, IranIntroduction Methotrexate (MTX) is a chemotherapy agent and immune system suppressant that can cause liver fibrosis in long-term usage. This study aimed to investigate the relationship between the dose of MTX and the incidence of liver fibrosis in patients with rheumatoid arthritis (RA). Material and methods This cohort study was conducted on RA patients with normal liver function who took MTX. Liver FibroScan and laboratory tests, including α 2 -macroglobulin, total bilirubin, g-glutamyltransferase, apolipoprotein A1, haptoglobin, and alanine transaminase was performed. The patients were divided into 2 groups regarding their cumulative dose of MTX and the rate of liver fibrosis incidence was compared between the 2 groups. Results In total, 60 RA patients with the mean age of 55.2 ±11.8 years were enrolled. The mean duration of MTX use in patients was 6.9 ±3.8 years, and it was higher in the higher cumulative dose MTX group (> 2 g) than in the lower cumulative dose group (< 2 g; p < 0.0001). The overall prevalence of grade 3 fibrosis was 3.33%. The prevalence of second- and third-degree liver fibrosis in patients receiving a lower cumulative dose was respectively 9 (28.1%) and 1 (3.1%), and in patients receiving a higher cumulative dose it was 7 (25%) and 1 (3.6%), respectively. There was no statistically significant difference between the 2 groups regarding the prevalence of liver fibrosis ( p = 0.88). Both aspartate aminotransferase to platelet ratio index and Fibrosis Index Based on 4 Factors indices showed no significant difference between the 2 groups ( p = 0.594, p = 0.232). Conclusions These results suggest that long-term treatment with a higher cumulative dose of MTX is not associated with a higher incidence of liver fibrosis in RA patients.https://reu.termedia.pl/The-relationship-between-dose-of-methotrexate-and-incidence-of-liver-fibrosis-in,199740,0,2.htmlmethotrexateliver fibrosiscumulative doserheumatoid arthritis |
| spellingShingle | Mina AkbariRad Zahra Rezaieyazdi Ali Tajik Banafshe Ataei Mehrdad Sarabi Hasan MehradMajd Hasan Vossoughinia Abdollah Firoozi The relationship between dose of methotrexate and incidence of liver fibrosis in patients with rheumatoid arthritis Rheumatology methotrexate liver fibrosis cumulative dose rheumatoid arthritis |
| title | The relationship between dose of methotrexate and incidence of liver fibrosis in patients with rheumatoid arthritis |
| title_full | The relationship between dose of methotrexate and incidence of liver fibrosis in patients with rheumatoid arthritis |
| title_fullStr | The relationship between dose of methotrexate and incidence of liver fibrosis in patients with rheumatoid arthritis |
| title_full_unstemmed | The relationship between dose of methotrexate and incidence of liver fibrosis in patients with rheumatoid arthritis |
| title_short | The relationship between dose of methotrexate and incidence of liver fibrosis in patients with rheumatoid arthritis |
| title_sort | relationship between dose of methotrexate and incidence of liver fibrosis in patients with rheumatoid arthritis |
| topic | methotrexate liver fibrosis cumulative dose rheumatoid arthritis |
| url | https://reu.termedia.pl/The-relationship-between-dose-of-methotrexate-and-incidence-of-liver-fibrosis-in,199740,0,2.html |
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