Methotrexate-induced liver fibrosis in chronic inflammatory diseases: A cross-sectional study in the Tunisian population.

Authors

Sarra Laabidi, Amal Hajlaoui, Maissa Abbes, Tayssir Ben Achour, Mariem Tabka, Donia Gouiaa, Fatma Said, Sahar Chtioui, Safa Rahmouni, Khaoula Zouaoui, Soumaya Boussaid, Sonia Rekik, Nadia Ben Mustapha, Mariem Serghini, Mourad Mokni, Hela Sahli, Asma Labidi, Monia Fekih

Published in

Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology. Oct 06, 2026. Epub Oct 06, 2026.

Abstract

Methotrexate (MTX) is an immunosuppressive drug used to treat various chronic inflammatory diseases. While its association with liver fibrosis is concerning, several associated factors appear to play a major role. This study aimed to assess the frequency of fibrosis in MTX-treated patients and identifies its associated factors.
A descriptive cross-sectional study was conducted including patients with chronic inflammatory diseases who had been on MTX for at least 6 months. Liver fibrosis was assessed using transient elastography. A comparative analysis was performed between patients with and without fibrosis, defined by liver stiffness >7 kPa.
A total of 160 patients were included (rheumatoid arthritis (45%), psoriasis (19%), Crohn's disease (19%)), with a mean age of 53.8 years and sex-ratio F/M = 2.1. The mean duration of MTX treatment was 38 months, with an average cumulative dose of 2.340 mg. Liver fibrosis, was detected in 11.9% of patients. In a multivariate study, independent factors associated with liver fibrosis included age > 59 years (OR = 18), alcohol consumption >15.17 g/day (OR = 4.2), metabolic syndrome (OR = 9), and obesity (OR = 18).
Liver fibrosis under MTX was observed in 11.9% of patients, influenced by advanced age, alcohol consumption, metabolic syndrome, and obesity. These findings highlight the need for targeted monitoring to prevent complications.

PMID:
42833957
Bibliographic data and abstract were imported from PubMed on 06 Oct 2026.

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