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Leflunomide increases the risk of silent liver fibrosis in patients with rheumatoid arthritis receiving methotrexate

Authors
 Sang-Won Lee  ;  Hee-Jin Park  ;  Beom Kyung Kim  ;  Kwang-Hyub Han  ;  Soo-Kon Leee  ;  Seung Up Kim  ;  Yong-Beom Park 
Citation
 Arthritis Research & Therapy, Vol.14(5) : 232-232, 2012 
Journal Title
 Arthritis Research & Therapy 
ISSN
 1478-6354 
Issue Date
2012
Abstract
ABSTRACT: INTRODUCTION: We identified silent liver fibrosis in patients with rheumatoid arthritis (RA) using transient elastography, and investigated medication that correlated with abnormal liver stiffness measurement (LSM) values. METHODS: We consecutively enrolled 105 patients with RA taking methotrexate over 24 weeks with normal liver functions and no history of underlying chronic liver disease. Blood tests were performed, and body mass index and metabolic syndrome were assessed. We checked LSM values, and adopted 5.3 kPa as the cutoff for abnormal LSM values. The cumulative doses of medications including methotrexate, leflunomide, sulfasalazine, hydroxychloroquine, prednisolone, meloxicam, and celecoxib were calculated. RESULTS: The median age of patients (20 men and 85 women) was 52.4 years. The median LSM value was 4.7 kPa and 24 (22.9%) patients had abnormal LSM values. Gamma-glutamyltranspeptidase levels and the cumulative doses of leflunomide and prednisolone significantly correlated with LSM values (P<0.05). The cumulative dose of leflunomide, but not methotrexate, was significantly higher in patients with abnormal LSM values than that in patients with normal LSM values (P = 0.008). When RA patients receiving leflunomide plus methotrexate were classified into two groups according to the optimal cutoff cumulative dose of leflunomide (19,170 mg), abnormal LSM values were more frequently identified in patients with high cumulative dose of leflunomide (odds ratio, 12.750; P<0.001). CONCLUSIONS: The cumulative dose of leflunomide was the only independent predictor of abnormal LSM values in patients with RA who had received methotrexate for more than six months.
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T201204312.pdf Download
DOI
10.1186/ar4075
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김범경(Kim, Beom Kyung) ORCID logo https://orcid.org/0000-0002-5363-2496
김승업(Kim, Seung Up) ORCID logo https://orcid.org/0000-0002-9658-8050
박용범(Park, Yong Beom)
박희진(Park, Hee Jin)
이상원(Lee, Sang Won) ORCID logo https://orcid.org/0000-0002-8038-3341
이수곤(Lee, Soo Kon)
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89635
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