Methotrexate does not increase cirrhosis risk in psoriatic patients with chronic viral hepatitis
Long-term methotrexate (MTX) use in psoriatic patients with chronic viral hepatitis does not appear to increase the risk of liver cirrhosis, a recent study has found.
Accessing the National Health Insurance Research Database of Taiwan, researchers enrolled 2,417 psoriatic patients with chronic hepatitis B (CHB). Of them, 370 were on MTX (mean age 42.6±13.2 years; 72 percent male) while 2,047 were not (mean age 42.1±14.5 years; 70 percent male). A parallel group of 1,127 chronic hepatitis C patients (CHC) were enrolled, of whom 174 were MTX users (mean age 50.4±12.6 years; 64 percent male) while 953 were not (54.5±14.0 years; 61 percent male).
Multivariate Cox proportional hazards analysis revealed that older age at hepatitis diagnosis was associated with a higher risk of liver cirrhosis both in CHC (adjusted hazard ratio [HR], 1.03; 95 percent CI, 1.02–1.05; p<0.001) and CHB (adjusted HR, 1.04; 1.03–1.05; p<0.001) participants.
Moreover, male CHB patients (adjusted HR, 1.85; 1.17–2.91; p<0.05) and those prescribed with hepatitis B virus medication (adjusted HR, 8.16; 5.96–11.7), as well as CHC patients with comorbid diabetes mellitus (adjusted HR, 1.64; 1.05–2.57; p<0.05), were at elevated risk of liver cirrhosis.
In both patient groups, longer intervals between the diagnosis of psoriasis and chronic viral hepatitis progressively and significantly reduced the risk of liver cirrhosis.
Concomitant use of MTX was not associated with significant cirrhosis risk in either the CHB (adjusted HR, 0.72; 0.42–1.25) or CHC (adjusted HR, 0.96; 0.58–1.57) groups.