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Determinants of serious liver disease among patients receiving low-dose methotrexate for rheumatoid arthritis
- Source :
- Arthritis & Rheumatism. 36:329-335
- Publication Year :
- 1993
- Publisher :
- Wiley, 1993.
-
Abstract
- Objective. To assess the risk of serious liver disease in patients with rheumatoid arthritis (RA) taking methotrexate (MTX). Methods. We surveyed members of the American College of Rheumatology to determine previous use of MTX in the treatment of rheumatoid arthritis and to identify cases of cirrhosis and liver failure. Cases were confirmed by review of pathology specimens, findings from diagnostic testing, and clinical presentations. A case—control study was then conducted to ascertain prognostic factors. Case and control medical records were reviewed for information on MTX therapy as well as other possible determinants of serious liver disease. Results. Twenty-four cases of cirrhosis and liver failure were identified, giving a 5-year cumulative incidence of ˜ 1/1,000 treated patients. Six of the 24 patients had died: 4 died of the initial liver disease, 1 of hepatic complications of another illness, and 1 of unrelated causes. Two patients continue to have active liver disease. Late age at first use of MTX and duration of therapy with MTX were independent predictors of serious liver disease. Conclusion. Serious liver disease is an uncommon, age- and dose-related complication of low-dose MTX therapy for RA.
- Subjects :
- Liver Cirrhosis
Male
musculoskeletal diseases
medicine.medical_specialty
Cirrhosis
Immunology
Hepatic Complication
Arthritis, Rheumatoid
Liver disease
Liver Function Tests
Rheumatology
Risk Factors
Internal medicine
medicine
Humans
Immunology and Allergy
Pharmacology (medical)
Cumulative incidence
Risk factor
Aged
Aged, 80 and over
business.industry
Incidence
Middle Aged
Prognosis
medicine.disease
Surgery
Methotrexate
Case-Control Studies
Rheumatoid arthritis
Female
business
Liver Failure
medicine.drug
Subjects
Details
- ISSN :
- 15290131 and 00043591
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Arthritis & Rheumatism
- Accession number :
- edsair.doi.dedup.....7baf9430d751448f6966bebfe81f1593
- Full Text :
- https://doi.org/10.1002/art.1780360307