Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology · 2026
Methotrexate-induced liver fibrosis in chronic inflammatory diseases: A cross-sectional study in the Tunisian population.
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Laabidi Sarra, Hajlaoui Amal, Abbes Maissa, Achour Tayssir Ben, Tabka Mariem, Gouiaa Donia, Said Fatma, Chtioui Sahar, Rahmouni Safa, Zouaoui Khaoula, Boussaid Soumaya, Rekik Sonia, Mustapha Nadia Ben, Serghini Mariem, Mokni Mourad, Sahli Hela, Labidi Asma, Fekih Monia
Аннотация
BACKGROUND AND STUDY AIMS: Methotrexate (MTX) is an immunosuppressive drug used to treat various chronic inflammatory diseases. While its association with liver fibrosis is concerning, several associated factors appear to play a major role. This study aimed to assess the frequency of fibrosis in MTX-treated patients and identifies its associated factors.
PATIENTS AND METHODS: A descriptive cross-sectional study was conducted including patients with chronic inflammatory diseases who had been on MTX for at least 6 months. Liver fibrosis was assessed using transient elastography. A comparative analysis was performed between patients with and without fibrosis, defined by liver stiffness >7 kPa.
RESULTS: A total of 160 patients were included (rheumatoid arthritis (45%), psoriasis (19%), Crohn's disease (19%)), with a mean age of 53.8 years and sex-ratio F/M = 2.1. The mean duration of MTX treatment was 38 months, with an average cumulative dose of 2.340 mg. Liver fibrosis, was detected in 11.9% of patients. In a multivariate study, independent factors associated with liver fibrosis included age > 59 years (OR = 18), alcohol consumption >15.17 g/day (OR = 4.2), metabolic syndrome (OR = 9), and obesity (OR = 18).
CONCLUSION: Liver fibrosis under MTX was observed in 11.9% of patients, influenced by advanced age, alcohol consumption, metabolic syndrome, and obesity. These findings highlight the need for targeted monitoring to prevent complications.
PATIENTS AND METHODS: A descriptive cross-sectional study was conducted including patients with chronic inflammatory diseases who had been on MTX for at least 6 months. Liver fibrosis was assessed using transient elastography. A comparative analysis was performed between patients with and without fibrosis, defined by liver stiffness >7 kPa.
RESULTS: A total of 160 patients were included (rheumatoid arthritis (45%), psoriasis (19%), Crohn's disease (19%)), with a mean age of 53.8 years and sex-ratio F/M = 2.1. The mean duration of MTX treatment was 38 months, with an average cumulative dose of 2.340 mg. Liver fibrosis, was detected in 11.9% of patients. In a multivariate study, independent factors associated with liver fibrosis included age > 59 years (OR = 18), alcohol consumption >15.17 g/day (OR = 4.2), metabolic syndrome (OR = 9), and obesity (OR = 18).
CONCLUSION: Liver fibrosis under MTX was observed in 11.9% of patients, influenced by advanced age, alcohol consumption, metabolic syndrome, and obesity. These findings highlight the need for targeted monitoring to prevent complications.