Use of Methotrexate for More Than 4 Years Is Not Associated with Liver Fibrosisin Rheumatoid Arthritis Patients

Abstract

v

Background. Methotrexate is an anchor drug in the management of
rheumatoid arthritis (RA). However, the association between methotrexate
and development of liver fibrosis remains a subject of controversy. Non invasive
methods
to
assess
liver
fibrosis,

such as the FIB-4 score, have been
developed. RA patients on methotrexate therapy should be monitored for any
signs of liver fibrosis. This study aims to investigate the correlation between
methotrexate cumulative dose and the FIB-4 score in rheumatoid arthritis
patients who received methotrexate therapy to assess the hepatotoxic effects
of methotrexate. Methods. This cross-sectional study involved rheumatoid
arthritis patients who received methotrexate therapy at Dr. Hasan Sadikin
General Hospital Bandung from September 2022 to November 2022. Clinical
data, laboratory tests (including platelet values and liver function test), and
cumulative methotrexate doses were extracted from medical records. Data
were analyzed using the Spearman correlation test. Results. This study
involved 100 subjects aged between 22-82 years, comprising 93% women and
7% men. The median FIB-4 score was 0.73 (0.24-6.80), while the median
methotrexate cumulative dose was 2477.5 mg, with a range of 1005-10400
mg. The results showed that correlation coefficient between the FIB-4 score
and methotrexate cumulative dose in rheumatoid arthritis patients was 0.089 (p=0.378).Conclusion.
There is no significant correlation between FIB 4
score and cumulative dose of methotrexate inrheumatoid, arthritis, patients. The use of methotrexate in RA patients
over 4 years is relatively
safe as it does not  increase the risk of liver
 fibrosis.