The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
Usefulness of noninvasive diagnostic procedures for assessment of methotrexate hepatotoxicity in patients with rheumatoid arthritis
Abstract
Methotrexate (MTX) is recommended as a first-line treatment for rheumatoid arthritis (RA). There are no strict guidelines regarding monitoring for liver damage in RA patients. This study aimed to evaluate noninvasive diagnostic procedures in assessing liver fibrosis in RA patients. Ninety-six RA patients were recruited for this study. The procollagen III N-terminal peptide (PIIINP) serum level was measured in all patients. The Enhanced Liver Fibrosis score (ELF-1) was calculated for 82 patients. Transient elastography (TE) was performed in 91 patients, those examined were divided into two groups: a study and control group, comprising patients with and without risk factors for liver fibrosis, respectively. The TE result correlated only with the body mass index—BMI (p < 0.05); there was no correlation with the cumulative MTX dose (p = 0.33). The TE result was significantly higher in those with risk factors for liver fibrosis than in those without risk factors (TE result > = 7.1 kPa 28/42 vs 13/41, HR = 2.103, Mann–Whitney U test, approximately 0.02). There was a positive correlation between the PIIINP level and body weight (p = 0.028), cumulative MTX dose (p = 0.007), RA activity (p = 0.028) and diabetes mellitus (DM) (p = 0.001). There was a positive correlation between the ELF-1 score and age (p < 0.001), cumulative MTX dose (p = 0.007) and RA activity (p < 0.001). The PIIINP level and ELF-1 score are not organ specific, and readings may vary depending on RA activity. TE is organ specific and can be performed by a skilled ultrasonographer might be useful to assess actual liver condition.
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“Substantial liver fibrosis on SWE was observed in about 5% of MTX-treated patients with RA and was associated with only a high body mass index, suggesting that other comorbidities might have a more important role in liver fibrosis [20].”
From Drug-induced liver injury. Part I: Classification, diagnosis and treatment (2025) · cites this paper as [20]
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Smolen, J. S., Landewé, R., Bijlsma, J. W. J., Burmester, G. R., Dougados, M., Kerschbaumer, A., McInnes, I. B., Sepriano, A. R., van Vollenhoven, R., de Wit, M. P. T., et al. (2020) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2019-216655 · Cited by 2,845
2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis
Singh, J. A., Saag, K. G., Bridges, S. L., Akl, E. A., Bannuru, R. R., Sullivan, M. C., Vaysbrot, E., McNaughton, C., Osani, M., Shmerling, R. H., et al. (2016) · Arthritis & Rheumatology · doi:10.1002/art.39480 · Cited by 2,777
Smolen, J. S., Landewé, R., Bijlsma, J., Burmester, G., Chatzidionysiou, K., Dougados, M., Nam, J., Ramiro, S., Voshaar, M., van Vollenhoven, R., et al. (2017) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2016-210715 · Cited by 2,057
(2015) · Journal of Hepatology · doi:10.1016/j.jhep.2015.04.006 · Cited by 1,875
2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis
Singh, J. A., Saag, K. G., Bridges, S. L., Akl, E. A., Bannuru, R. R., Sullivan, M. C., Vaysbrot, E. E., McNaughton, C., Osani, M. C., Shmerling, R. H., et al. (2015) · Arthritis Care & Research · doi:10.1002/acr.22783 · Cited by 1,158
Serum markers detect the presence of liver fibrosis: A cohort study
Rosenberg, W. M., Voelker, M., Thiel, R. P., Becka, M., Burt, A. D., Schuppan, D., Hübscher, S. G., Roskams, T., Pinzani, M., & Arthur, M. J. P. (2004) · Gastroenterology · doi:10.1053/j.gastro.2004.08.052 · Cited by 1,120
Pathirana, D., Ormerod, A., Saïag, P., Smith, C. H., Spuls, P. I., Nast, A., Barker, J. N., Bos, J. D., Burmester, G. R., Chimenti, S., et al. (2009) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/j.1468-3083.2009.03389.x · Cited by 711
Menter, A., Gelfand, J. M., Connor, C. J., Armstrong, A. W., Cordoro, K. M., Davis, D. M. R., Elewski, B. E., Gordon, K. B., Gottlieb, A. B., Kaplan, D. H., et al. (2020) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2020.02.044 · Cited by 389
Mikolasevic, I., Orlic, L., Franjic, N., Hauser, G., Stimac, D., & Milic, S. (2016) · World Journal of Gastroenterology · doi:10.3748/wjg.v22.i32.7236 · Cited by 273
Hepatotoxicity of statins and other lipid‐lowering agents
Björnsson, E. S. (2017) · Liver International · doi:10.1111/liv.13308 · Cited by 173
Cited by
Drug-induced liver injury. Part I: Classification, diagnosis and treatment
Kozielewicz, D. M., Stalke, P., & Skrzypek, J. (2025) · Clinical and Experimental Hepatology · doi:10.5114/ceh.2025.148329 · Cited by 19
Metadata
- Authors
- Frankowski, M., Świerkot, J., Gomułkiewicz, M., Korman, L., Skoczyńska, M., & Starba, A.
- Venue
- Rheumatology International
- Published
- 2021-12-06
- Volume
- 42
- Issue
- 4
- Pages
- 631-638
- ISSN
- 0172-8172
- 1437-160X
- PMC
- PMC8940880
- Cited by
- 11
- References
- 30
- Language
- en
- Funders
- Uniwersytet Medyczny im. Piastów Slaskich we Wroclawiu (STM.A270.20.111)
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