Session Type: Abstract Submissions (ACR)
Methotrexate (MTX) is a widely used drug for treatment of rheumatoid arthritis (RA), and a concern with drug-related liver fibrosis is an unsolved problem. ShearWave elastography (SWE) is a newly developed, repeatable and reproducible real-time elastography technique for the evaluation of liver fibrosis. This study aimed to detect the associated factors with liver stiffness (LS) in patients taking MTX with RA.
Methods: We prospectively analyzed a total of 171 patients (female 135, mean age 54.3±9.4 years) with RA who underwent SWE, serum sample and arthropometric measurement on the same day (August 2011-February 2012). Also, we calculated MTX cumulative dose and duration. LS measured by SWE is expressed in kilo-Pascal (kPa) with mean value. Based on the previous our study, significant fibrosis defines as liver stiffness above 7.0 kPa. The factors associated with liver fibrosis were evaluated by univariate and multivariate analysis using SPSS 19.0 Statistical Software.
Among 171 patients, 37 paients (21.6%) had SWE results suggesting significant fibrosis. In univariate analysis, body weight, body mass index (BMI), waist circumference, serum AST, ALT, HDL, glucose, and metabolic component were associated with liver fibrosis (p<0.05). Neither MTX cumulative dose (4768±3145 mg vs. 4870±3436 mg, p=0.87) nor MTX duration (330±203 weeks vs. 338±196 weeks, p=0.84) was associated with elevated liver stiffness. In multivariate analysis, only BMI ≥ 25kg/m2 (odds ratio 18.9, 95% confidence interval 4.0-91.2, p<0.001) and serum AST levels (expB=1.198, 95%CI 1.008-1.251, p=0.036) were associated with significant fibrosis.
Conclusion: Significant fibrosis by SWE was detected in about 20% of patients taking MTX with RA, and was associated with only high BMI and serum AST levels, but not MTX cumulative dose and duration.
T. Y. Kim,
S. Y. Bang,
J. H. Sohn,
H. S. Lee,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/liver-fibrosis-evaluated-by-shearwave-elastograpy-is-associated-with-body-mass-index-and-serum-ast-but-not-methotrexate-cumulative-dose-and-duration-in-patients-with-rheumatoid-arthritis/