Interest of Fibroscan in the Evaluation and Follow-Up of Liver Fibrosis Induced By Methotrexate.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Introduction: Fibroscan allows non-invasive study of liver fibrosis and has recently been proposed in the follow-up of patients treated with methotrexate (MTX) in the long term for chronic inflammatory diseases. The purpose of this study is to evaluate by Fibroscan the degree of liver fibrosis induced by MTX in patients with various inflammatory diseases, comparing patients who received MTX to those naive or at the beginning of treatment. Materials and methods: This is a prospective, descriptive and analytical study carried out in the gastroenterology, dermatology and rheumatology departments of Hassan II university hospital center, FĂ©sMorocco, from January 2011 to December 2012, including all adult patients who received different cumulative doses of MTX being explored by Fibroscan (group 1: n = 42), and compared to controls never treated or at the start of treatment (group 2: n = 43). The threshold of 7.1 was used to define a significant fibrosis> F2. Results: During this period, 85 patients were included, with an average age of 44 years, with a slight female predominance of 67%. Among these patients, 31 were followed for psoriasis, 26 for other dermatological diseases, 17 for rheumatoid arthritis (RA) and 11 for chronic inflammatory bowel diseases (IBD). In group 1, the average BMI was 23.2, the average cumulative dose of MTX received was 1245 mg [105-5280 mg] for an average treatment duration of 67 weeks [13-190 weeks]. In the total population studied, the average value of Fibroscan was 4.2 KPa. Mean values of Fibroscan were not different between the two groups (4.12 VS 4.35: P> 0.05). The cumulative dose of MTX was greater than 1500 mg in 15 patients, of whom 13 were followed for PR, one for psoriasis and the other for dermatomyositis. The comparison of this group of patients with those receiving a dose <1500 mg had not shown significant differences in liver stiffness (4.17 VS 4.18: p> 0.05). Conclusion: The risk of liver fibrosis during long-term treatment with MTX, regardless of indication, appears to be low and not related to cumulative dose or the duration of therapy.
Authors and Affiliations
M. Azouaoui, B. Benyachou, M. El Yousfi, I. Mellouki, D. Benajah, A. Ibrahimi, N. Aqodad
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