Background: Methotrexate (MTX) use is associated with hepatic fibrosis in psoriasis patients. To monitor this serial liver biopsies were performed. The Fibroscan® and the Fibrotest are two novel, non-invasive methods that might be able to assess MTX-induced hepatic fibrosis. Aim: Evaluating the accuracy and feasibility of the Fibroscan® and Fibrotest to detect significant MTX-induced liver fibrosis in psoriasis patients. Methods: We assessed 24 psoriasis patients who had a recent liver biopsy during MTX use. The results from the Fibroscan® and Fibrotest were compared with liver histology. Results: Fibroscan® values (n=20) ranged between 3.3 and 18.4kPa (median value 6.4kPa) and correctly identified 88% of the patients without significant liver fibrosis (Metavir score <F2, Fibroscan® ≤7.1kPa). The Fibrotest identified 83% of the patients with significant liver fibrosis (Metavir score ≥F2, Fibrotest >0.31). Conclusion: In this population, Fibrotest accurately predicted the presence of significant liver fibrosis while the Fibroscan® accurately predicted the absence of significant liver fibrosis in MTX users. This suggests that a combination of Fibrotest and Fibroscan® should prospectively be evaluated in monitoring and detecting significant MTX-induced liver fibrosis in psoriasis patients.

Additional Metadata
Keywords Liver fibrosis and non-invasive methods, Methotrexate, Psoriasis
Persistent URL dx.doi.org/10.1111/j.1478-3231.2007.01489.x, hdl.handle.net/1765/36909
Citation
Berends, M.A.M, Snoek, J, de Jong, E.M, van Krieken, J.H.J.M, de Knegt, R.J, van Oijen, M.G.H, … Drenth, J.P.H. (2007). Biochemical and biophysical assessment of MTX-induced liver fibrosis in psoriasis patients: Fibrotest predicts the presence and Fibroscan® predicts the absence of significant liver fibrosis. Liver International, 27(5), 639–645. doi:10.1111/j.1478-3231.2007.01489.x