Dr Peter Rosenberg and colleagues from Sweden and Switzerland investigated the impact of diabetes mellitus type 2 on liver fibrosis in psoriasis patients treated with methotrexate.
They also studied other factors, including; overweight, alcohol over-consumption, and chronic hepatitis B or C as risk factors.
169 liver biopsies from 71 patients who underwent liver biopsies as part of the monitoring of methotrexate treatment for psoriasis were reviewed.
|38% of the patients with risk factors had severe fibrosis|
|Journal of Hepatology|
Fibrosis, steatosis and inflammation were staged according to the NAFLD activity score.
26 patients had one or more of the risk factors and 25 (96%) of these (median cumulative dose methotrexate 1500mg) developed liver fibrosis.
Of those without a risk factor, 26 (58%) (p=0.012) developed fibrosis (median cumulative dose methotrexate 2100mg).
10 (38%) of the patients with risk factor(s) had severe fibrosis (stage 3-4) (mean cumulative dose methotrexate 1600mg), while four (9%) (p=0.0012) of those without risk factors had severe fibrosis (median cumulative dose methotrexate 1900mg).
Dr Rosenberg concluded that, "Patients with methotrexate treated psoriasis and risk factors for liver disease, especially diabetes type 2 or overweight, are at higher risk of developing severe liver fibrosis compared to those without such risk factors, even when lower cumulative methotrexate doses are given".