Methotrexate-Associated Nonalcoholic Fatty Liver Disease with Transaminitis in Rheumatoid ArthritisReportar como inadecuado

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The Scientific World JournalVolume 2014 2014, Article ID 823763, 5 pages

Clinical Study

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433

Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia

Received 26 January 2014; Revised 3 May 2014; Accepted 17 May 2014; Published 28 May 2014

Academic Editor: Raimon Sanmartí

Copyright © 2014 Rajalingham Sakthiswary et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The aim of this study was to determine the risk factors of MTX-associated nonalcoholic fatty liver disease NAFLD with transaminitis in a cohort of rheumatoid arthritis RA patients from Singapore. Methods. Patients who developed ultrasound proven NAFLD with transaminitis while on MTX therapy were identified. The demographic and clinical characteristics of the above patients cases were compiled and compared with age- and gender-matched controls who were RA patients on long standing MTX therapy without any episode of transaminitis. Results. Among the 978 patients who had received MTX, the prevalence of MTX-associated NAFLD was 4.7% 46 patients. Compared to the controls, the cases had significantly higher mean cumulative dose of MTX 4.03 ± 2.25 g versus 10.04 ± 9.94 g, , weekly dose of MTX 11.3 ± 4.8 mg versus 13.1 ± 4.4 mg weekly, , and fasting blood glucose . Following multivariate regression analysis, only cumulative dose of MTX remained significant . Among the cases, the cumulative dose of MTX was found to have a significant positive correlation with the alanine transaminase ALT level , standardised beta coefficient 0.512. Conclusion. The cumulative dose of MTX was the only independent predictor of MTX-associated NAFLD with transaminitis.

Autor: Rajalingham Sakthiswary, Grace Yin Lai Chan, Ee Tzun Koh, Khai Pang Leong, and Bernard Yu Hor Thong



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