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

Abstract

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. Evaluating the accuracy and feasibility of the Fibroscan and Fibrotest to detect significant MTX-induced liver fibrosis in psoriasis patients. 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. Fibroscan values (n=20) ranged between 3.3 and 18.4 kPa (median value 6.4 kPa) and correctly identified 88% of the patients without significant liver fibrosis (Metavir score <F2, Fibroscan</=7.1 kPa). The Fibrotest identified 83% of the patients with significant liver fibrosis (Metavir score >/=F2, Fibrotest >0.31). 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.