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Comparison of fibrosis-4 index and severity of hepatic fibrosis by fibroscan in rheumatoid arthritis patients under treatment with methotrexate
Majid Salmanian Mashhadi , Anoushe Haghighi, Nahid Kianmehr, Marjan Mokhtare, Sara Zarasvandnia, Parna Hosseini Meigoni , Seyede Maryam Mirghorbani ,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Liver fibrosis is a major concern associated with long-term side effects among patients with rheumatoid arthritis (RA) treated with methotrexate. The aim of the present study was to compare the fibrosis-4 (FIB-4) index and the results of liver fibrosis severity derived from FibroScan device in rheumatoid arthritis patients who were treated with methotrexate.
Methods: The present cross-sectional study was conducted in 70 RA patients referred to rheumatology clinic of Hazrat Rasool Akram Hospital, Tehran, from July 2022 to July 2023. First, FIB-4 was calculated and the data from transient elastography, which was performed using a FibroScan device to diagnose liver fibrosis for each patient, will be compared with the results of the FIB-4 of each patient. Furthermore, the correlation between FIB-4 index and FibroScan grade with demographic characteristic, methotrexate dose and disease duration was also evaluated.
Results: The average age of patients was 59.59±11.75 and most of them (74.3%) were women. Most patients (75.71%) with a normal to mild FIB-4 index stage had a normal to mild elastography stage. of patients had normal to mild liver fibrosis. FibroScan grade were not related to the age, gender, body mass index, methotrexate dose and duration of the disease (P>0.05). The average FIB-4 was 1.25±0.6, which was not significantly related to gender, body mass index, disease duration and methotrexate dose but directly related to the age of patients (P<0.001, (CL95%, 0.51-0.53)).The correlation between FIB-4 and FibroScan grade of the patients showed a positive association, which was not statistically significant (P=0.594, r=0.06, CL95%, -0.24-0.4). The FIB-4 in normal to mild grade was 85% rejecting the moderate to severe grade in FibroScan but none of them were statistically significant (P=0.146).
Conclusion: Overall, the FIB-4 was incapable of predicting the FibroScan result. On the contrary, this case was also inconclusive and the results of FibroScan did not justify FIB-4 results of the patients. The FIB-4 cannot replace in RA patients. It is recommended to conduct future studies with a larger sample size in RA patients.

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