Hépatologie et science pancréatique

Liver Elastography for Methotrexate-induced Fibrosis

Abstract

Rosella Diane*

Methotrexate is a cornerstone medication in the management of various autoimmune diseases, including rheumatoid arthritis, psoriasis, and inflammatory bowel disease. However, its use is associated with the risk of liver toxicity, including fibrosis, which can progress to cirrhosis in severe cases. Liver elastography has emerged as a valuable tool for non-invasive assessment of liver fibrosis, offering significant advantages over traditional biopsy. This article explores the application of liver elastography in detecting and monitoring MTX-induced liver fibrosis. MTX is an antimetabolite and antifolate drug that exerts its therapeutic effects by inhibiting dihydrofolate reductase, thus interfering with folate metabolism. While highly effective in managing autoimmune conditions, MTX can lead to hepatotoxicity, with liver fibrosis being a common manifestation. The exact pathogenesis of MTX-induced liver fibrosis is multifactorial and not fully elucidated but likely involves oxidative stress, inflammatory cytokines, and genetic predisposition.