New research by Dr Paul Collins and colleagues in the Charles Clinic for dermatology at St. Vincent’s University Hospital could provide alternative, pain-free monitoring of patients undergoing treatment with methotrexate.
Methotrexate is used frequently as a treatment for patients with severe psoriasis. As methotrexate can cause liver damage, patients have regular blood tests to check liver function as well as periodic liver biopsies to detect any development of liver disease.
Not only is the liver biopsy procedure painful, it can damage the liver and in rare instances cause death. The aim of this study was to assess alternative, non-invasive methods of methotrexate treatment monitoring in seventy-seven psoriasis patients.
Dr Collins and his team used FibroTest, a blood test to detect liver fibrosis, and an ultrasound imaging technique called transient elastography that measures liver stiffness to monitor these patients.
The findings of the research team published recently in Journal of the American Medical Association Dermatology showed that using these two non-invasive tools to detect liver disease could reduce the need for a liver biopsy.
The team now hope to evaluate this strategy in further on-going large scale controlled clinical trials.
M Lynch, E Higgins, PA McCormick, B Kirby, N Nolan, S Rogers, A Lally, A Vellinga, H Omar, P Collins. The Use of Transient Elastography and FibroTest for Monitoring Hepatotoxicity in Patients Receiving Methotrexate for Psoriasis. JAMA Dermatol. doi:10.1001/jamadermatol.2013.9336. Published online June 25, 2014 LINK: http://archderm.jamanetwork.com/article.aspx?articleid=1883731