Biochemical and biophysical assessment of MTX-induced liver fibrosis in psoriasis patients: Fibrotest predicts the presence and Fibroscan predicts the absence of significant liver fibrosis

Liver Int. 2007 Jun;27(5):639-45. doi: 10.1111/j.1478-3231.2007.01489.x.


Background: Methotrexate (MTX) use is associated with hepatic fibrosis in psoriasis patients. To monitor this serial liver biopsies were performed. The Fibroscan and the Fibrotest are two novel, non-invasive methods that might be able to assess MTX-induced hepatic fibrosis.

Aim: Evaluating the accuracy and feasibility of the Fibroscan and Fibrotest to detect significant MTX-induced liver fibrosis in psoriasis patients.

Methods: We assessed 24 psoriasis patients who had a recent liver biopsy during MTX use. The results from the Fibroscan and Fibrotest were compared with liver histology.

Results: Fibroscan values (n=20) ranged between 3.3 and 18.4 kPa (median value 6.4 kPa) and correctly identified 88% of the patients without significant liver fibrosis (Metavir score <F2, Fibroscan</=7.1 kPa). The Fibrotest identified 83% of the patients with significant liver fibrosis (Metavir score >/=F2, Fibrotest >0.31).

Conclusion: In this population, Fibrotest accurately predicted the presence of significant liver fibrosis while the Fibroscan accurately predicted the absence of significant liver fibrosis in MTX users. This suggests that a combination of Fibrotest and Fibroscan should prospectively be evaluated in monitoring and detecting significant MTX-induced liver fibrosis in psoriasis patients.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Artificial Intelligence
  • Biopsy
  • Dermatologic Agents / adverse effects*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Liver / diagnostic imaging*
  • Liver / pathology
  • Liver Cirrhosis / chemically induced
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / diagnostic imaging
  • Male
  • Methotrexate / adverse effects*
  • Middle Aged
  • Psoriasis / drug therapy*
  • Ultrasonography


  • Dermatologic Agents
  • Methotrexate