Ab0590 Correlation Between Cumulative Methotrexate Dose, Metabolic Syndrome and Hepatic Fibrosis Detected by Fibroscan in Patients Receiving Methotrexate in Rheumatoid Arthritis in Comparison With Psoriatic Arthritis

Background: Methotrexate (MTX) has been recommended as the first-line treatment in the American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology (EULAR) guidelines for rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Long-term MTX usage possesses a known side-effect of hepatic fibrosis, which is associated with high cumulative MTX dosage and metabolic syndrome. Both RA and PsA patients have a higher incidence of metabolic syndrome. Objectives: We try to compare the correlation between hepatic fibrosis, cumulative MTX dosage, metabolic syndrome, and clinical parameters between RA and PsA patients. Methods: RA and PsA prescribed MTX patients were evaluated for hepatic fibrosis by using transient elastography (TE). The two subgroups were compared. Linear regression analysis was performed to determine clinical factors correlated with hepatic fibrosis. Results: Two hundred and ninety-five patients were recruited. There were one hundred and eighty-five patients in the RA group. The PsA group had one hundred and ten patients. TE was used as an investigation tool for hepatic fibrosis detection, which was found in 28.6% and 45.5% of RA and PsA, respectively. There were higher body mass index (BMI), metabolic syndrome, duration of disease, and hepatic fibrosis in the PsA group. Whereas cumulative MTX dosage and MTX dose per weight were comparable between the two groups. The linear regression analysis demonstrated statistical significance only in the association of hepatic fibrosis with metabolic syndrome (regression coefficient 3.677; 95% CI 2.748-4.605; P<0.001) and psoriatic arthritis (regression coefficient 0.62; 95% CI 0.051-1.189; P=0.033). Notably, MTX dosage was not associated with hepatic fibrosis (regression coefficient 0.03; 95% CI -0.008-0.013; P=0.616). Conclusion: Hepatic fibrosis measured with Fibroscan was correlated with metabolic syndrome and psoriatic arthritis. PsA also had a higher incidence of metabolic syndrome, which emphasized the occurrence of hepatitis fibrosis in this group of patients. MTX-prescribed patients with risk factors (i.e. metabolic syndrome and psoriatic arthritis) should be vigilantly monitored for hepatitis fibrosis. REFERENCES: NIL. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.