Factores asociados para hepatitis en pacientes con artritis inflamatoria en tratamiento con metrotexato.

Abstract

INTRODUCTION: Methotrexate is a DMARD used for the treatment of different rheumatic diseases, one of its most remarkable adverse reactions is hepatitis. METHODOLOGY: Longitudinal and retrospective analytical study. IRHED and HTMC databases in the period 2009-2022. OBJECTIVES: To evaluate the factors associated with elevated liver enzymes in patients with inflammatory arthritis who initiate methotrexate. RESULTS: Of the 1908 patients in the universe of patients, only 400 had rheumatological diseases, after applying inclusion and exclusion criteria, a sample of 100 consecutive patients was selected. Among them, 46% were patients with rheumatoid arthritis, 45% with psoriatic arthritis, 4% with Rhupus, 3% with ankylosing spondylitis. Regarding the altered transaminase values, psoriatic arthritis accounted for 64.46%, followed by rheumatoid arthritis 28.10%, rhupus 4.96%, ankylosing spondylitis with 2.48%. Spearman's correlation between the absolute value of BMI and the first control of ALT p = 0.001. CONCLUSIONS: BMI above normal ranges was the major predictor for elevated liver enzymes in patients after initiation of methotrexate treatment. Psoriatic arthritis has a higher prevalence of altered transaminase values. Psoriatic arthritis was a associated with elevated liver enzymes in patients starting methotrexate.