Objective: To evaluate the impact of TNFα blockers on the presence of liver fibrosis in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) treated with methotrexate (MTX).
Methods: Subjects were consecutive patients with RA and PsA who had undergone MTX treatment for at least one year +/- TNF blockade for over 6 months. Liver fibrosis was assessed using non-invasive transient elastography (FibroScan). Regression models were used to compare FibroScan values of RA and PsA patients receiving TNFα blockers with those who were not.
Results: FibroScan assessments were performed on 51 RA and 43 PsA patients. Compared to RA patients, those with PsA were predominantly young males, received lower cumulative dosages of MTX and exhibited a higher incidence of liver steatosis and hyperlipidemia. An abnormal result was observed in 7.1% of the anti-TNFα-naïve and in 13% of the anti-TNFα-treated patients in the RA group, and in 30% of the anti-TNFα-naïve and 4.3% of the anti-TNFα-treated patients in the PsA group (OR = 0.11, 95% CI 0.02 to 0.98). Results of the PsA group were robust when adjusted for baseline characteristics.
Conclusion: The results suggest a protective effect of TNFα inhibitors against the development of liver fibrosis in patients with PsA.