Transient Elastography in Methotrexate Administered Patients

Background: As Methotrexate (MTX) may induce liver side effects or damage, evaluating the liver of the consumers of this drug by a noninvasive method, such as FibroScan, may be effective. Objectives: The present study aimed at evaluating the progression of liver fibrosis and steatosis using the transient elastography (FibroScan) technique in patients, who are treated with MTX. Methods: One hundred and one patients, who were treated with MTX because of different rheumatologic diagnosis and/or dermatologic disease, were included in the study. Liver stiffness was measured using FibroScan. Hepatic fibrosis was identified by converting the FibroScan results measured in kPa to the Metavir scale. Also, F0-F4 and steatosis were graded. Results: The assessment of steatosis using FibroScan showed mild, moderate, and severe stenosis in 15.8%, 13.9%, and 26.7%, respectively. With regards to grading of hepatic fibrosis, 67.0% were graded as F0 to F1, 7.0% as F2, 7.0% as F2 to F3, 2.0% as F3, 11.0% as F3 to F4, and 6.0% as F4. A significant association was found between body mass index, waist circumferences, and fibrosis. The association between the severity of hepatic fibrosis and indices of alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), and serum albumin was significant. No relationship was revealed between the severity of hepatic fibrosis and MTX dosage as well as duration of MTX use. Conclusions: The authors found significant associations between hepatic steatosis and anthropometric parameters, level of albumin, drug dosage higher than 10 mg, and cumulative dosage of MTX. The severity of hepatic fibrosis and steatosis induced by MTX was mainly affected by the patients' obesity.