Risk of Liver Fibrosis in Methotrexate-Treated Patients: A Systematic Review.
hepatic cirrhosis
liver cirrhosis
liver enzymes
liver fibrosis
methotrexate
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
27
07
2022
accepted:
31
10
2022
entrez:
5
12
2022
pubmed:
6
12
2022
medline:
6
12
2022
Statut:
epublish
Résumé
Methotrexate (MTX), an antifolate agent, is recommended as the first-line disease-modifying antirheumatic drug (DMARD). In this systematic review, our goals were to assess liver fibrosis in methotrexate-treated patients, evaluate liver fibrosis in relation to treatment duration and cumulative dose, and identify differences based on the underlying disease. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to perform the systematic review. We thoroughly searched PubMed, PubMed Central (PMC), and Cochrane library databases to identify relevant articles based on predefined selection criteria. Studies were selected based on the following predefined eligibility criteria: English language, papers from the last 20 years, systematic reviews, observational studies, randomized controlled trials (RCTs), and clinical trials, which included papers on MTX playing roles in the development of liver fibrosis with the derived data transferred to a template. Following that, quality was assessed using the appropriate assessment tool for each study. The initial search yielded 512 results. Following a thorough review, 10 studies were chosen for final consideration: eight observational studies and two systematic reviews. Liver enzyme (LE) elevations during MTX therapy are a common but transient problem. Serial abnormal LE tests may be associated with liver pathology, but fibrosis development is uncommon. However, it is unclear from the literature how therapy should be adjusted in the case of elevated LE and to what extent MTX is linked to liver toxicity; definitive conclusions cannot be drawn because more research is needed.
Identifiants
pubmed: 36465792
doi: 10.7759/cureus.30910
pmc: PMC9711916
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
e30910Informations de copyright
Copyright © 2022, Bichenapally et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Ann Rheum Dis. 2005 Mar;64 Suppl 2:ii74-7
pubmed: 15708943
Arthritis Care Res (Hoboken). 2012 May;64(5):625-39
pubmed: 22473917
J Ultrasound Med. 2015 Sep;34(9):1621-30
pubmed: 26269292
J Rheumatol. 2002 Nov;29(11):2442-5
pubmed: 12415606
Rheumatology (Oxford). 2009 May;48(5):569-72
pubmed: 19273538
Arch Dermatol. 2007 Dec;143(12):1515-9
pubmed: 18087000
Br J Rheumatol. 1995 Nov;34 Suppl 2:43-8
pubmed: 8535649
J Am Acad Dermatol. 1980 Feb;2(2):171-4
pubmed: 7364974
Clin Rheumatol. 2021 Sep;40(9):3605-3613
pubmed: 33686476
Aliment Pharmacol Ther. 2006 Jun 1;23(11):1621-8
pubmed: 16696812
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Rheumatology (Oxford). 2002 Dec;41(12):1367-74
pubmed: 12468815
J Hepatol. 2010 Dec;53(6):1035-40
pubmed: 20801541
Joint Bone Spine. 2010 Dec;77(6):588-92
pubmed: 20471892
Br J Dermatol. 1980 Apr;102(4):407-12
pubmed: 7387883
Ann Rheum Dis. 2003 Oct;62(10):944-51
pubmed: 12972472
Br J Dermatol. 2014 Jul;171(1):17-29
pubmed: 24606161
Rheumatology (Oxford). 2000 Sep;39(9):975-81
pubmed: 10986302
J Am Acad Dermatol. 1998 Mar;38(3):478-85
pubmed: 9520032
Arthritis Rheum. 1995 Aug;38(8):1115-9
pubmed: 7639808
Med Clin (Barc). 2011 Nov 26;137(14):637-9
pubmed: 21719043
Br J Dermatol. 2016 Jul;175(1):9-10
pubmed: 27484263
Clin Exp Rheumatol. 2009 Nov-Dec;27(6):1017-25
pubmed: 20149325
Ann Rheum Dis. 2014 Mar;73(3):492-509
pubmed: 24161836