Sökning: id:"swepub:oai:DiVA.org:ltu-73727" >
Methotrexate treatm...
Methotrexate treatment in rheumatoid arthritis and elevated liver enzymes : A long‐term follow‐up of predictors, surveillance, and outcome in clinical practice
-
- Sundbaum, Johanna (författare)
- Uppsala universitet,Luleå tekniska universitet,Medicinsk vetenskap,Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden,Reumatologi,Lulea Univ Technol, Dept Hlth Sci, Lulea, Sweden
-
- Eriksson, Niclas, 1978- (författare)
- Uppsala universitet,Klinisk farmakogenomik och osteoporos,Science for Life Laboratory, SciLifeLab,Department of Medical Sciences, Clinical Pharmacology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
-
- Hallberg, Pär, 1974- (författare)
- Uppsala universitet,Klinisk farmakogenomik och osteoporos,Science for Life Laboratory, SciLifeLab,Department of Medical Sciences, Clinical Pharmacology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
-
visa fler...
-
- Lehto, Niklas (författare)
- Luleå tekniska universitet,Medicinsk vetenskap,Lulea Univ Technol, Dept Hlth Sci, Lulea, Sweden
-
- Wadelius, Mia (författare)
- Uppsala universitet,Klinisk farmakogenomik och osteoporos,Science for Life Laboratory, SciLifeLab,Department of Medical Sciences, Clinical Pharmacology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
-
- Baecklund, Eva, 1956- (författare)
- Uppsala universitet,Reumatologi,Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden
-
visa färre...
-
(creator_code:org_t)
- John Wiley & Sons, 2019
- 2019
- Engelska.
-
Ingår i: International Journal of Rheumatic Diseases. - : John Wiley & Sons. - 1756-185X .- 1756-1841. ; 22:7, s. 1226-1232
- Relaterad länk:
-
https://doi.org/10.1...
-
visa fler...
-
https://uu.diva-port... (primary) (Raw object)
-
https://urn.kb.se/re...
-
https://doi.org/10.1...
-
https://urn.kb.se/re...
-
visa färre...
Abstract
Ämnesord
Stäng
- AimTo assess predictors of alanine aminotransferase (ALT) elevation in methotrexate (MTX) treated rheumatoid arthritis (RA) patients, and to describe the monitoring of liver enzymes, including handling and outcome of elevated ALT.MethodsAll RA patients starting MTX in January, 2005 to April, 2013 at a rheumatology clinic, (Uppsala University Hospital, Sweden) were identified from electronic medical records. Clinical and laboratory data were obtained from medical records, supplemented by telephone interviews. Predictors for ALT >1.5× over the upper limit of normal (ULN) were identified by multiple regression analysis.ResultsThe study comprised 213 RA patients starting MTX. During a mean follow‐up of 4.3 years, 6288 ALT tests were performed; 7% of tests with ALT were >ULN. ALT >1.5× ULN was observed in 44 (21%) patients and the strongest predictor was a pre‐treatment elevation of ALT (adjusted odds ratio = 6.8, 95% CI 2.2‐20.5). Recurrent elevations occurred in 70% of patients who continued treatment, and the proportion was similar in those with and without interventions, for example MTX dose reduction (67% vs 73%, P = 0.43). Seven patients (3%) permanently stopped MTX due to ALT elevation, and two were eventually diagnosed with non‐alcoholic fatty liver disease. No patient developed hepatic failure.ConclusionOnly a small number of ALT tests performed during MTX therapy in RA capture an elevation. A pre‐treatment elevation of ALT was the strongest predictor for early and recurrent ALT elevations during therapy. This study supports a more individualized approach to monitoring and handling of ALT elevations during MTX therapy in RA than recommended in current guidelines.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Annan hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Other Health Sciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Nyckelord
- liver toxicity
- liver transaminases
- methotrexate
- non‐alcoholic fatty liver disease
- rheumatoid arthritis
- Health Science
- Hälsovetenskap
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas