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Psoriasis patients with diabetes type 2 are at high risk of developing liver fibrosis during methotrexate treatment

Rosenberg, Peter, Urwitz, Hanna, Johannesson, Anders, Ros, Anne-Marie, Lindholm, Johan, Kinnman, Nils, Hultcrantz, Rolf·2007·Journal of Hepatology
DOI 10.1016/j.jhep.2007.01.024
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Abstract

Background/aims We investigated the impact of diabetes mellitus type 2, overweight, alcohol over-consumption, and chronic hepatitis B or C as risk factors, for liver fibrosis in psoriasis patients treated with methotrexate. Methods One hundred and sixty-nine liver biopsies from 71 patients who underwent liver biopsies as part of the monitoring of methotrexate treatment for psoriasis were reviewed. Fibrosis, steatosis and inflammation were staged according to the NAFLD activity score. Results Twenty-six patients had one or more of the risk factors and 25 (96%) of these (median cumulative dose methotrexate 1500 mg) developed liver fibrosis. Of those without risk factor, 26 (58%) (p=0.012) developed fibrosis (median cumulative dose methotrexate 2100 mg). Ten (38%) of the patients with risk factor(s) had severe fibrosis (stage 3-4) (mean cumulative dose methotrexate 1600 mg), while four (9%) (p=0.0012) of those without risk factors had severe fibrosis (median cumulative dose methotrexate 1900 mg). Conclusions Patients with methotrexate treated psoriasis and risk factors for liver disease, especially diabetes type 2 or overweight, are at higher risk of developing severe liver fibrosis compared to those without such risk factors, even when lower cumulative methotrexate doses are given.

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Crossref · 10.1016/j.jhep.2007.01.024

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  • Diabetes or obesity may increase the risk of liver injury induced by certain drugs such as tamoxifen and methotrexate.

    “Current evidence does not support the opinion that diabetes or obesity increase susceptibility to all-cause DILI [5], although they may increase the risk of liver injury induced by certain drugs such as tamoxifen and methotrexate [44,45].”

    From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [45]

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Metadata

Authors
Rosenberg, P., Urwitz, H., Johannesson, A., Ros, A.-M., Lindholm, J., Kinnman, N., & Hultcrantz, R.
Venue
Journal of Hepatology
Publisher
Elsevier BV
Published
2007-06
Volume
46
Issue
6
Pages
1111-1118
ISSN
0168-8278
DOI
10.1016/j.jhep.2007.01.024
Cited by
185
References
1
Language
en
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)

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