{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:36:52Z","timestamp":1789655812095,"version":"4.0.1"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T00:00:00Z","timestamp":1647388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Up to 3% of methotrexate (MTX)\u2010treated rheumatoid arthritis (RA) patients might develop liver fibrosis or cirrhosis, requiring effective screening algorithms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the utility of non\u2010invasive liver fibrosis assessment in RA patients on MTX.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010six patients were recruited from rheumatology outpatient clinics in a public tertiary centre from July 2017 to October 2018. Clinical data was collected. Screening for hepatic fibrosis was performed using transient elastography (TE), aminoaspartate transaminase to platelet ratio index (APRI), Hepascore and Fibrosis\u20104 index (FIB\u20104). Those with suspected significant liver fibrosis based on these screening tests were assessed by a hepatologist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven patients were suspected to have liver fibrosis on screening, including 10\/56 (18%) by TE, 20\/56 (36%) by Hepascore, 2\/56 by APRI (4%) and 1\/56 by FIB\u20104 (2%). Of these 27 patients, 11 were reviewed by a hepatologist and one diagnosed with significant liver fibrosis. TE, but not APRI, Hepascore or FIB\u20104, was found to have 100% sensitivity and 84% specificity (<jats:italic>P<\/jats:italic> =\u20090.029) for hepatologist\u2010diagnosed liver fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Liver fibrosis develops in a minority of MTX\u2010treated RA patients. The present study suggests that TE is a more sensitive screening test than APRI, FIB\u20104 or Hepascore in the identification of people with RA at risk of hepatic fibrosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.15125","type":"journal-article","created":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T02:45:10Z","timestamp":1604285110000},"page":"566-573","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Assessment of liver fibrosis markers in people with rheumatoid arthritis on methotrexate"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4799-1783","authenticated-orcid":false,"given":"Debbie A.","family":"Olsson\u2010White","sequence":"first","affiliation":[{"name":"Department of Rheumatology Fiona Stanley Fremantle Hospital Group  Perth Western Australia 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