Non-alcoholic steatohepatitis-like pattern in liver biopsy of rheumatoid arthritis patients with persistent transaminitis during low-dose methotrexate treatment

PloS One
Shunsuke MoriYukitaka Ueki

Abstract

The mechanism of liver injury with low-dose methotrexate (MTX) is incompletely understood. This study was designed to evaluate the association between non-alcoholic fatty liver disease (NAFLD) and liver injury during MTX treatment for rheumatoid arthritis (RA). Between October 2014 and May 2015, we enrolled all MTX users for RA and monitored participant serum hepatic transaminase levels for 1 year. All patients had normal transaminase levels before the first MTX prescription. Using diagnostic criteria for non-alcoholic steatohepatitis (NASH), we performed histological analyses for patients presenting persistent transaminitis, defined as elevations of hepatic transaminases in four of six determinations during the follow-up period. Possible risk factors for persistent transaminitis were also examined. We followed 846 RA patients with a mean cumulative MTX dose of 2.48 g and identified 51 patients presenting persistent transaminitis. According to multivariate logistic regression analysis, obesity (odds ratio [OR] 3.23, p < 0.001), type 2 diabetes (OR 3.52, p = 0.001), hypercholesterolemia (OR 2.56, p = 0.004), and hyperuricemia (OR 3.52, p = 0.019), which are recognized as risk factors for NAFLD, were independently associated with...Continue Reading

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Citations

Aug 3, 2020·Current Rheumatology Reports·Dilli PoudelJoshua F Baker
Nov 5, 2020·Expert Opinion on Biological Therapy·Ciro RomanoGiovanna Cuomo
Mar 27, 2021·The Australasian Journal of Dermatology·Ali AzzamJames O'Beirne
Aug 18, 2020·European Journal of Gastroenterology & Hepatology·Jordina LlaóEugeni Domènech

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Methods Mentioned

BETA
biopsies
biopsy
imaging technique

Software Mentioned

PASW Statistics
SPSS

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