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The effect of long-term methotrexate therapy on hepatic fibrosis in rheumatoid arthritis

D J Bjorkman1, M Boschert, K G Tolman

  • 1Division of Gastroenterology, University of Utah College of Medicine, Salt Lake City.

Arthritis and Rheumatism
|December 1, 1993
PubMed
Abstract

Insights

Methotrexate (MTX) therapy for rheumatoid arthritis (RA) may lead to hepatic fibrosis in some patients. A study found increased liver collagen in five of 15 RA patients after two years of MTX treatment.

Area of Science:

  • Rheumatology
  • Hepatology
  • Pharmacology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
  • Methotrexate (MTX) is a common disease-modifying antirheumatic drug (DMARD) used for RA.
  • Liver toxicity is a known potential side effect of MTX therapy.

Purpose of the Study:

  • To investigate the potential progression of hepatic fibrosis in patients with rheumatoid arthritis (RA) undergoing methotrexate (MTX) treatment.
  • To assess the long-term effects of MTX on liver health in RA patients.

Main Methods:

  • Prospective study design.
  • Inclusion of 15 patients with RA treated with MTX.
  • Electron microscopic analysis of liver biopsy specimens to evaluate hepatic collagen levels.

Main Results:

  • After two years of MTX therapy, five out of 15 patients (33.3%) showed evidence of increased hepatic collagen.
  • This indicates a potential for MTX-induced liver fibrosis in a subset of RA patients.

Conclusions:

  • Hepatic fibrosis can progress in a subgroup of rheumatoid arthritis patients receiving methotrexate.
  • Regular monitoring of liver function and potential fibrosis is recommended for RA patients on long-term MTX therapy.

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