Work

Longitudinal FIB-4 and APRI Monitoring in Psoriatic Arthritis: Associations with Cumulative Methotrexate Exposure and Biologic Therapy Class

Year: 2026

Type: article

Abstract: Background: Psoriatic arthritis (PsA) is associated with hepatic risk, but longitudinal data during methotrexate (MTX) and biologic therapy are limited. We evaluated two-year changes in age-fixed FIB-4 and APRI and their associations with cumulative MTX exposure and biologic class. Methods: This retrospective cohort included 74 patients receiving continuous biologic therapy for 24 months. Baseline age was used to calculate FIB-4 at both time points. Logistic regression assessed factors associated with FIB-4 ≥ 1.3 at follow-up. Results: Forty-five patients received anti-TNF therapy and 29 received an IL-17 inhibitor. Age-fixed FIB-4 increased from 1.26 ± 0.44 to 1.72 ± 0.73 (p < 0.001); APRI did not change significantly (0.21 ± 0.08 to 0.23 ± 0.15; p = 0.155). No significant differences in either index were detected between biologic groups. Each 500-mg increase in documented cumulative MTX exposure was associated with higher odds of FIB-4 ≥ 1.3 (OR 2.164, 95% CI 1.04–4.41; p = 0.038). Conclusions: Greater documented cumulative MTX exposure was associated with FIB-4 ≥ 1.3 in an exploratory model. The findings neither establish a causal MTX effect nor demonstrate equivalence between biologic classes and require prospective validation against elastography or histology.

Source: Biologics

DOI: 10.3390/biologics6030025

Authors: Mehmet Serkan Kılıçoğlu, Safa El Mardi Alaoui, Ozan Volkan Yurdakul, Ayşegül Yabacı Tak, Teoman Aydın

Institution: Bezmiâlem Vakıf Üniversitesi

Language: English

Topic: Spondyloarthritis Studies and Treatments

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,207