HealthDay News — For patients with psoriasis receiving long-term methotrexate sodium therapy, a noninvasive test for nonalcoholic steatohepatitis (NASH) and hepatic fibrosis (NASH FibroSure) can be used to monitor development of methotrexate-induced hepatotoxic effects, with a significant correlation for cumulative methotrexate dose with higher score in women, but not men, according to research published online in JAMA Dermatology.1
Bruce Bauer, MD, from Pariser Dermatology Specialists in Norfolk, Virginia, and colleagues conducted a retrospective descriptive analysis among patients with psoriasis treated with methotrexate who underwent NASH FibroSure testing at a dermatology referral center. Data were included for 129 patients with psoriasis receiving methotrexate treatment, while 107 patients underwent NASH FibroSure testing during methotrexate therapy.
The researchers found that 53.5% of the 129 patients underwent NASH FibroSure testing before starting methotrexate; 27.5% and 78.3% of those had elevated fibrosis and steatosis scores, respectively. Among the 107 patients who underwent NASH FibroSure testing during methotrexate therapy, there was a significant correlation for cumulative methotrexate dose with higher NASH FibroSure hepatic fibrosis score in women (P = .02), but not men (P = .11). Except for one patient, all were managed without liver biopsy.
“In a single-institution cohort, these results suggest that NASH FibroSure may be used, especially among female patients, to help monitor for risk of worsening fibrosis during methotrexate therapy,” the authors write.
- Bauer B, Chyou PH, Stratman EJ, Green C. Noninvasive testing for nonalcoholic steatohepatitis and hepatic fibrosis in patients with psoriasis receiving long-term methotrexate sodium therapy [published online August 23, 2017]. JAMA Dermatol. doi: 10.1001/jamadermatol.2017.2083