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Methotrexate is not associated with increased liver cirrhosis in a population-based cohort of rheumatoid arthritis patients with chronic hepatitis C

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ABSTRACT

A few studies have shown that methotrexate (MTX) use exacerbates liver fibrosis and even leads to liver cirrhosis in rheumatoid arthritis (RA) patients, although the risk is low compared to psoriatics. We therefore conducted a population-based cohort study to investigate the impact of long-term MTX use on the risk of chronic hepatitis C (CHC)-related cirrhosis among RA patients. We analyzed data from the National Health Insurance Research Database in Taiwan and identified 450 incident cases of RA among CHC patients (255 MTX users and 195 MTX non-users) from January 1, 1998 to December 31, 2007. After a median follow-up of more than 5 years since the diagnosis of CHC, a total of 55 (12%) patients developed liver cirrhosis. We did not find an increased risk of liver cirrhosis among CHC patients with long-term MTX use for RA. Furthermore, there was no occurrence of liver cirrhosis among the 43 MTX users with a cumulative dose ≧3 grams after 108 months of treatment. In conclusion, our data showed that long-term MTX use is not associated with an increased risk for liver cirrhosis among RA patients with CHC. However, these results should be interpreted with caution due to potential bias in the cohort.

No MeSH data available.


Probability of liver cirrhosis-free survival among MTX users with different cumulative doses and MTX non-users (p < 0.001, log-rank test).MTX, methotrexate.
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f2: Probability of liver cirrhosis-free survival among MTX users with different cumulative doses and MTX non-users (p < 0.001, log-rank test).MTX, methotrexate.

Mentions: Figure 2 illustrates the Kaplan-Meier survival analysis of liver cirrhosis-free survival with respect to MTX use among RA patients with CHC. The probability of liver cirrhosis-free survival was positively correlated with MTX use in a dose-dependent manner: the highest probability was in MTX users with a cumulative dose of ≧1.5 grams, and the lowest probability was in MTX non-users (p < 0.001, log-rank test).


Methotrexate is not associated with increased liver cirrhosis in a population-based cohort of rheumatoid arthritis patients with chronic hepatitis C
Probability of liver cirrhosis-free survival among MTX users with different cumulative doses and MTX non-users (p < 0.001, log-rank test).MTX, methotrexate.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016832&req=5

f2: Probability of liver cirrhosis-free survival among MTX users with different cumulative doses and MTX non-users (p < 0.001, log-rank test).MTX, methotrexate.
Mentions: Figure 2 illustrates the Kaplan-Meier survival analysis of liver cirrhosis-free survival with respect to MTX use among RA patients with CHC. The probability of liver cirrhosis-free survival was positively correlated with MTX use in a dose-dependent manner: the highest probability was in MTX users with a cumulative dose of ≧1.5 grams, and the lowest probability was in MTX non-users (p < 0.001, log-rank test).

View Article: PubMed Central - PubMed

ABSTRACT

A few studies have shown that methotrexate (MTX) use exacerbates liver fibrosis and even leads to liver cirrhosis in rheumatoid arthritis (RA) patients, although the risk is low compared to psoriatics. We therefore conducted a population-based cohort study to investigate the impact of long-term MTX use on the risk of chronic hepatitis C (CHC)-related cirrhosis among RA patients. We analyzed data from the National Health Insurance Research Database in Taiwan and identified 450 incident cases of RA among CHC patients (255 MTX users and 195 MTX non-users) from January 1, 1998 to December 31, 2007. After a median follow-up of more than 5 years since the diagnosis of CHC, a total of 55 (12%) patients developed liver cirrhosis. We did not find an increased risk of liver cirrhosis among CHC patients with long-term MTX use for RA. Furthermore, there was no occurrence of liver cirrhosis among the 43 MTX users with a cumulative dose &#8807;3&thinsp;grams after 108 months of treatment. In conclusion, our data showed that long-term MTX use is not associated with an increased risk for liver cirrhosis among RA patients with CHC. However, these results should be interpreted with caution due to potential bias in the cohort.

No MeSH data available.