Psoriatic patients with chronic viral hepatitis do not have an increased risk of liver cirrhosis despite long-term methotrexate use: Real-world data from a nationwide cohort study in Taiwan

被引:15
作者
Tang, Kuo-Tung [1 ]
Chen, Yi-Ming [1 ,3 ]
Chang, Shih-Ni [2 ]
Lin, Ching-Heng [2 ]
Chen, Der-Yuan [4 ,5 ]
机构
[1] Taichung Vet Gen Hosp, Div Allergy Immunol & Rheumatol, Taichung, Taiwan
[2] Taichung Vet Gen Hosp, Dept Med Res, 1650,Sec 4 Taiwan Blvd, Taichung 40705, Taiwan
[3] Natl Yang Ming Univ, Fac Med, Taipei, Taiwan
[4] China Med Univ Hosp, Rheumatol & Immunol Ctr, 2 Yude Rd, Taichung 40447, Taiwan
[5] China Med Univ, Coll Med, Taichung, Taiwan
关键词
chronic hepatitis B; chronic hepatitis C; cirrhosis; hepatotoxicity; liver; methotrexate; psoriasis; viral hepatitis; RHEUMATOID-ARTHRITIS PATIENTS; VIRUS-INFECTION; DISEASE; BIOPSIES; HEPATOTOXICITY; FIBROSIS;
D O I
10.1016/j.jaad.2018.05.004
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100227 [皮肤病学];
摘要
Background: Methotrexate (MTX) is commonly used in the treatment of patients with moderate-to-severe psoriasis. Objective: We conducted a nationwide population-based cohort study to investigate the impact of long-term MTX use on the risk of chronic viral hepatitis-related cirrhosis among psoriatic patients in Taiwan. Methods: This study obtained data from the National Health Insurance Research Database in Taiwan. We identified 2417 psoriatic patients with chronic hepatitis B (CHB) (370 MTX users and 2047 nonusers of MTX) and 1127 psoriatic patients with chronic hepatitis C (CHC) (174 MTX users and 953 nonusers of MTX) from January 1, 2000, to December 31, 2010. Results: After a mean follow-up of more than 9 years since the diagnosis of chronic viral hepatitis, a total of 125 patients with CHB (5%) and 120 patients with CHC (11%) developed liver cirrhosis. Comparable proportions of MTX users and nonusers of MTX developed liver cirrhosis (4% vs 5% in patients with CHB and 11% vs 11% in patients with CHC [both P>.05]). Limitations: There is possible selection bias and medication nonadherence. Conclusion: Our real-world data show that long-term MTX use may not be associated with an increased risk of liver cirrhosis among psoriatic patients with chronic viral hepatitis.
引用
收藏
页码:652 / 658
页数:7
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