Background/Purpose: Only limited data are available on the risk of liver fibrosis in patients with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) on long-term methotrexate (MTX) treatment, despite MTX association with a range of liver related adverse events there are also controversial results. As a result, common extra-articular manifestation is the leading cause of mortality in RA. Thus, there is a need of liver fibrosis formation predictors and its reparation capacity learning in children with juvenile idiopathic arthritis (JIA) to reduce future risks.

Purpose of our study was to evaluate serum levels of hepatocyte growth factor (HGF) in children with juvenile idiopathic arthritis treated with methotrexate.

Methods: 104 patients with JIA were included in this 4-years prospective study. Almost half of children had polyarthritis (50,96%) JIA variant. In 104 children with JIA (mean age 13.3 yrs, 59,62 % female, mean age of JIA onset 7.2 yrs, mean disease duration 5.06 yrs) were treated with MTX 75.96 % (vs. 24.04 % not treated with MTX, 16,35 % were prescribed MTX, but they didnt receive any dose yet on investigation day). Among patients treated with MTX 4.81% had dose less than 10 mg/m²/week, 32.69 % 10-12.5 mg/m²/week, 31.73 % 12.6 – 15 mg/m²/week, 6.73 % over 15 mg/m²/week. HGF levels were determined by HGF ELISA kits (Elabscience, USA). Serum levels of HGF were analyzed depending on patients gender, age, and age of JIA onset, its variant, duration, activity, and presence of MTX in treatment and its dose. Levels of rheumatoid factor (RF), antinuclear antibodies (ANA), erythrocyte sedimentation rate (ESR), C-reactive protein (C-RP), circulating immune complex (CIC) and antistreptolysin-O (ASL-O) were analyzed in this study. This work complies with the guiding principles found in the Declaration of Helsinki of the World Medical Association.

Results: We evaluated HGF level for children with JIA (min: 89.13 pg/ml; Me:168.04 pg/ml; max: 629.13 pg/ml). The average level of HGF significantly increased in children with age of JIA onset from 6 to 10years versus age of JIA onset 11–14 years (p = 0.009). Mostly HGF was correlated with CIC (among: patients with no activity according to JADAS-27 r= -0.99, p ˂ 0.05, high disease activity according to JADAS-27 r=0.95, p ˂ 0.05), with MTX dose (among: girls r= -0.38, p ˂ 0.05). According to regression analysis, HGF in children with JIA depended on the age of the patients, JADAS 27, АNА, RF and MTX mg/m²/week.

Conclusion: CIC and MTX dose were corresponded with high HGF level. Lower serum HGF, which can be considered as inhibition of the reparative capabilities of the liver, were mainly in girls, in patients aged 10–13 years, with the JIA onset at 3–5 years, polyarticular variant and high JIA activity according to JADAS-27.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/serum-hepatocyte-growth-factor-in-children-with-juvenile-idiopathic-arthritis/