Transient Elastography in Methotrexate Administered Patients

Mansour-Ghanaei, Fariborz; Erfani, Ali; Shafaghi, Afshin; Joukar, Farahnaz; Hajiabasi, Asghar; Zayeni, Habib; Darjani, A; Roushan, Zahra Atrkar; Mansour-Ghanaei, Alireza; Jafroudi, Ehsan Hajipour

doi:10.5812/hepatmon.57917

Cited by 4 publications

(6 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, significant and severe fibrosis was observed in 3 patients. In a similar study, out of 160 patients with long-term RA treatment with MTX with a median cumulative dose of 4225 mg, only 12 of them reported significant fibrosis (21). Therefore, the occurrence of severe renal fibrosis measured in TE is not as common as in our study.…”

Section: Evaluation Of Tgfβ Gene Expressionsupporting

confidence: 45%

“…In the study of Kumar et al (15), which included 160 patients with RA treated with low-dose MTX for more than five years, no significant relationship was observed between the duration of use and the cumulative dose of renal fibrosis. Mansour-Ghanaei et al (21) also examined the kidney of 101 patients with psoriasis and RA by TE treated with methotrexate for at least two years and did not find a significant relationship between the presence of renal fibrosis with cumulative dose and duration of methotrexate use. Unlike the previous two studies, obese and alcoholics were also examined in this study.…”

Section: Evaluation Of Tgfβ Gene Expressionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluating the effect of methotrexate on the rate of renal fibrosis by elastography and fibrosis-related gene expression

Wang

Jiang²,

Shang

et al. 2022

Cell Mol Biol (Noisy-le-grand)

View full text Add to dashboard Cite

Methotrexate is mainly used to treat diseases such as rheumatoid arthritis (RA), but its potential for nephrotoxicity has always been a significant concern on the use of this medication. This study aimed to determine the rate of renal fibrosis using transient elastography and its relationship with cumulative dose and duration of drug use in patients with rheumatoid arthritis treated with methotrexate. TGFβ gene expression was also assessed for further evaluation. Patients with rheumatoid arthritis who received methotrexate for more than six months were included. Renal fibrosis was determined by measuring the stiffness of the kidney by elastography (FiberScan Device). RA patients were divided into two groups based on kidney stiffness measurement with and without renal fibrosis, and demographic, clinical, and biochemical parameters were compared to investigate the relationship between cumulative dose and duration of methotrexate treatment and renal fibrosis. Also, in this study, 50 controls (healthy people) and 50 cases (RA patients) were used to evaluate the expression of the TGFβ gene by real-time PCR method. The existence of kidney fibrosis was observed in 10 patients. There was no significant relationship between renal fibrosis and the cumulative dose (P = 0.21) and duration of methotrexate (P = 0.30). Multivariate regression analysis showed that the chances of developing renal fibrosis in patients increase with increasing serum ALT levels (P = 0.01). The results of the TGFβ gene expression showed that the expression of this gene in the group of RA patients with fibrosis was higher than the control group (healthy people) and the group of RA patients without fibrosis (P <0.01). These results showed that evaluation of renal fibrosis by elastography method is recommended for scanning RA patients while they are being treated with methotrexate, which is also confirmed by the results of the fibrosis-related-gene expression.

show abstract

Section: Evaluation Of Tgfβ Gene Expressionsupporting

confidence: 45%

Section: Evaluation Of Tgfβ Gene Expressionmentioning

confidence: 99%

Evaluating the effect of methotrexate on the rate of renal fibrosis by elastography and fibrosis-related gene expression

Wang

Jiang²,

Shang

et al. 2022

Cell Mol Biol (Noisy-le-grand)

View full text Add to dashboard Cite

show abstract

“…We present further convincing data supporting the use of non-invasive markers of fibrosis and steatosis to guide the treatment of rheumatologic and dermatologic diseases. TE has been used to advise which patients on MTX have already developed fibrosis ( 12 – 14 ). However, our study shows that an increased CAP score can advise which patients are at increased risk of fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…Transient elastography (TE) is a non-invasive measure of hepatic fibrosis that has been used in patients on MTX ( 12 – 14 ). TE measures the stiffness (or elasticity) of the hepatic parenchyma using both ultrasound and low-frequency elastic waves produced by an ultrasound vibrator applied to the right upper quadrant to measure the propagation speed of a wave using a pulse-echo ultrasound ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Hepatic steatosis as measured by the computed attenuation parameter predicts fibrosis in long-term methotrexate use

Tomaszewski

Dahiya

Mohajerani

et al. 2021

CanLivJ

View full text Add to dashboard Cite

Introduction: To determine predictors of hepatic steatosis by the computed attenuation parameter (CAP) and fibrosis via transient elastography (TE) in persons on methotrexate (MTX) therapy with rheumatologic and dermatologic diseases. Methods: A single-centred retrospective cohort study was performed. Patients on >6 months of MTX for a rheumatologic or dermatologic disease who had undergone TE from January 2015 to September 2019 were included. Multivariate analysis was performed to determine predictors of steatosis and fibrosis. Results: A total of 172 patients on methotrexate were included. Psoriasis was the most frequent diagnosis ( n = 55), followed by rheumatoid arthritis ( n = 45) and psoriatic arthritis ( n = 34). Steatosis (CAP ≥245 dB/m) was present in 69.8% of patients. Multivariate regression analysis revealed that diabetes mellitus (OR 10.47, 95% CI 1.42–75.35), hypertension (OR 5.15, 95% CI 1.75–15.38), and BMI ≥30 kg/m2 (OR 16.47, 95% CI 5.56–45.56) were predictors of steatosis (CAP ≥245 dB/m). Predictors of moderate to severe fibrosis (Metavir ≥F2 = TE ≥8.0kPa) by multivariate regression analysis included moderate to severe steatosis (CAP ≥270 dB/m) (OR 8.36, 95% CI 1.88–37.14), diabetes mellitus (OR 2.85, 95% CI 1.09–7.48), hypertension (OR 5.4, 95% CI 2.23–13.00), dyslipidemia (OR 3.71, 95% CI 1.50–9.18), and moderate alcohol use (OR 3.06, 95% CI 1.2–7.49). Conclusions: In patients on MTX for rheumatologic and dermatologic diseases, hepatic steatosis as measured by CAP was common and moderate to severe steatosis predicted moderate to severe fibrosis.

show abstract

“…[ 17 ] Hepatic fibrosis was staged to convert Fibroscan results (measured in kPa) to the Metavir scoring system as follows: F0 (no fibrosis), F1 (mild fibrosis without septa), F2 (moderate fibrosis with few septa), F3 (severe fibrosis with numerous septa without cirrhosis), and F4 (cirrhosis or advanced scarring of the liver). [ 18 ]…”

Section: Methodsmentioning

confidence: 99%

Major Dietary Patterns in Association with the Grades of Nonalcoholic Fatty Liver Disease in Newly Diagnosed Patients Living in North of Iran

Mansour‐Ghanaei

Mahdavi-Roshan

Darabi

et al. 2022

International Journal of Preventive Medicine

View full text Add to dashboard Cite

Background: Evidence suggests that dietary pattern is related to incidence and grades of nonalcoholic fatty liver disease (NAFLD). The aim of this study was to investigate the relationship between major dietary patterns and hepatic histologic features of newly diagnosed patients with NAFLD. Methods: This cross-sectional study included 260 newly diagnosed NAFLD patients. Hepatic fibrosis and steatosis were diagnosed using Fibroscan. Dietary information was obtained using a validated 168-item semiquantitative food frequency questionnaire. The association between dietary patterns and odds ratio of the grade of fibrosis and steatosis was examined by multinomial logistic regression. Results: The mean ± SD age participant was 46.53 ± 11.71 years. Fifty-seven percent of the participants were women. Two major dietary patterns were recognized: “Western dietary pattern” and “Mediterranean dietary pattern.” After adjustment for various confounders, adherence to the two extracted dietary patterns was not associated with odds of fibrosis and steatosis (P > 0.05). However, P was not significant. Patients in the second quartile of the Mediterranean dietary pattern had a higher risk for being in the F1 grade compared to those in the reference group in the crude and adjusted model. Conclusions: The major dietary patterns of NAFLD patients living in Gilan were not related to the severity of their disease. More precise study design such as cohort or interventional studies is suggested to reveal the strength of this study findings.

show abstract

Transient Elastography in Methotrexate Administered Patients

Abstract: Background: As Methotrexate (MTX) may induce liver side effects or damage, evaluating the liver of the consumers of this drug by a noninvasive method, such as FibroScan, may be effective.

Cited by 4 publications

References 24 publications

Evaluating the effect of methotrexate on the rate of renal fibrosis by elastography and fibrosis-related gene expression

Evaluating the effect of methotrexate on the rate of renal fibrosis by elastography and fibrosis-related gene expression

Hepatic steatosis as measured by the computed attenuation parameter predicts fibrosis in long-term methotrexate use

Major Dietary Patterns in Association with the Grades of Nonalcoholic Fatty Liver Disease in Newly Diagnosed Patients Living in North of Iran

Contact Info

Product

Resources

About