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Transient elastography, FibroTest effective for hepatotoxicity monitoring in psoriasis patients

Researchers found transient elastography and FibroTest to be effective, noninvasive tools for hepatoxicity monitoring in patients with psoriasis who are treated with methotrexate.

The researchers recruited 77 patients undergoing methotrexate monotherapy for psoriasis from a dermatology outpatient department. Transient elastography (TE) and FibroTest — an indirect serum marker for fibrosis — were performed. The researchers also recorded serial procollagen III peptide (PIIINP) results. Patients with abnormal TE and FibroTest results were considered for liver biopsy.

Fifty patients were found to have a valid TE assessment and nine had an abnormal result. Patients who were overweight or obese had significantly increased chances of obtaining an invalid TE test. Age was also correlated with abnormal TE results, according to the researchers.

A total of 71 patients received a FibroTest and 11 had an abnormal result. Age, cumulative methotrexate dose and duration of methotrexate therapy were all correlated abnormal results.

No correlations were observed between PIIINP levels and TE or FibroTest results.

Based on normal TE or FibroTest results within the reference range, three liver biopsies could have been avoided, according to the researchers.

The researchers concluded that within this population, an abnormal result on two of three tests (PIIINP, TE and FibroTest) can reduce the need for liver biopsy.

See the study for a full list of all authors’ relevant financial disclosures.