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THU0194 The role of enhanced liver fibrosis (ELF) score in patients with rheumatoid arthritis treated with methotrexate
  1. J Swierkot1,
  2. M Frankowski2,
  3. M Skoczynska2,
  4. A Starba2,
  5. MS Gomulkiewicz3,
  6. P Wojtala2,
  7. M Bujak3
  1. 1Department of Rheumatology and Internal Medicine, Medical University Wroclaw
  2. 2Department of Rheumatology and Internal Medicine
  3. 3Department of Radiology, Wroclaw University Hospital, Wroclaw, Poland


Background MTX is still a basic medicament used in treatment of patients with RA. One of its adverse reaction is its hepatoxicity. Previous studies have established high diagnostic accuracy of the ELF score to assess hepatic fibrosis in chronic viral hepatitis and fatty liver disease.

Objectives The aim of the research was the evaluation of the usefulness of ELF markings, by patients treated with MTX, as an indicator which shows potential liver damage.

Methods In the research were analyzed results of 96 patients with RA treated with MTX. Average age of patients was 60 (19–85 years old), median of body mass was 70 kg (46–140), median of BMI was 26 (16–46). Average time of taking MTX were 4 years and median of the accumulated dose was 3140 mg (12,5–27400mg). Disease activity in the moment of evaluation, evaluated by DAS 28, was 4,3 (0,98–8,42).

Achieved results ELF, PIIINP were correlated with body mass, BMI, dose of MTX, other illnesses (e.g. diabetes), taken nonsteroidal anti-inflammatory drugs and statins. In statistical analysis were used Pearson correlation and U Mann-Whitney test.

Results The ELF values correlated with age, accumulated dose and DAS 28. Along with the increase of accumulated dose of MTX, disease activity and by older patients, were observed higher ELF values (the differences were statistically significant). The PIIINP values correlated with patients' body mass, accumulated dose of MTX and disease activity, evaluated by DAS 28. The differences were statistically significant. Along with the increase of body mass, accumulated dose and DAS 28, were observed higher values of PIIINP. Patients with diabetes had statistically higher values of PIINP (average: 11.13, median: 11,38), than patients without diabetes (average: 8.06, median: 7.15). There was observed no relationship between ELF and PIIINP results with taken nonsteroidal anti-inflammatory drugs and statins.

Conclusions The ELF test, and one of its elements, PIIINP, may be useful in the evaluation of patients with higher probability of hepatotoxic effect of MTX. Special attention should be paid to older, obese patients, with diabetes, patients who take higher accumulated dose of MTX and with higher disease activity.

Disclosure of Interest None declared

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