ปัจจัยที่สัมพันธ์กับค่าความแข็งของตับในผู้ป่วยโรคสะเก็ดเงินที่ได้รับยาเมโทเทรกเซต

Manasalak Ariyachaipanich

doi:10.64960/srimedj.v41i5.271032

Authors

Manasalak Ariyachaipanich Dermatologist, Department of Medicine, Surin Hospital, Mueang District, Surin Province, Thailand 3200

DOI:

https://doi.org/10.64960/srimedj.v41i5.271032

Keywords:

psoriasis, methotrexate, liver stiffness, associated factors

Abstract

Objective: To study the clinical factors independently associated with Liver Stiffness Measurement (LSM) by Transient Elastography among psoriatic patients receiving Methotrexate at tertiary care hospital.

Methods: A retrospective cross-sectional study was conducted among 26 patients treated with MTX who underwent Transient Elastography examination between 2020-2026. Descriptive statistics were used to characterize the baseline data, and Multiple Linear Regression was employed to identify independent predictors of liver stiffness. Clinical confounders were controlled, with statistical significance set at < 0.05.

Results: The majority of the sample was male (57.7%), with a median age of 49 years and a median weight of 74 kg. Most patients (61.5%) had a cumulative dose ≤ 1.5 g. The median liver stiffness was 5.8 kPa (IQR: 4.6–6.6). Multivariable analysis revealed that total bilirubin showed the strongest positive association (beta = 24.6, 95% CI: 17.8–31.5, p < 0.001), followed by aspartate aminotransferase (AST) levels (beta = 0.3, 95% CI: 0.1–0.5, p = 0.004). This model explained 91.9% of the variance in LSM (adjusted R2 = 0.919). However, total cumulative dose and duration of treatment showed no statistically significant association with liver stiffness (p = 0.738 and 0.381, respectively).

Conclusion: Serum total bilirubin and AST levels showed stronger association with liver stiffness than cumulative MTX dose in this study. However, given the high adjusted R² in a small sample, these findings should be interpreted with caution and confirmed in larger prospective studies

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