Prevalence and risk factors of methotrexate hepatoxicity in Asian patients with psoriasis

Table 1 Roenigk classification of liver damage

Grade	Fibrosis	Fatty infiltration	Nuclear variability	Portal inflammation
I	None	Mild	Mild	Mild
II	None	Moderate to severe	Moderate to severe	Portal expansion, lobular necrosis
IIIA	Mild (Septa extending into lobules)	Moderate to severe	Moderate to severe	Portal expansion, lobular necrosis
IIIB	Moderate to severe	Moderate to severe	Moderate to severe	Portal expansion, lobular necrosis
IV	Cirrhosis

Table 2 Distribution of the grades of the liver histology and the median cumulative dose

Histology grade	No.	Median MTX cumulative dose (mg)
Normal	6	2285
I	62	2885
II	23	1800
III	7	1500
IV	0	-
Total	98	2500

MTX: Methotrexate.

Table 3 Risk factors analysis for fibrosis and progression of Roenigk grades n (%)

Risk factor	Proportion of patients with fibrosis	P value1	Proportion of patients with progression	P value1
Gender (male vs female)	4/42 (9.5) vs 3/17 (17.6)	0.382	5/9 (55.6) vs 4/17 (23.5)	0.102
Ethnicity (Chinese vs non-Chinese)	4/39 (10.3) vs 3/20 (15)	0.594	3/16 (18.8) vs 6/10 (60)	0.031
Diabetes mellitus (yes vs no)	5/15 (33) vs 2/44 (4.4)	0.008	4/5 (80) vs 5/21 (23.8)	0.018
Hyperlipidemia (yes vs no)	1/9 (11.1) vs 6/50 (11.7)	> 0.99	3/3 (100) vs 6/23 (26.1)	0.011
Hypertension (yes vs no)	5/15 (33) vs 2/44 (4.4)	0.008	4/6 (66.7) vs 5/20 (25)	0.060
Alcohol consumption (yes vs no)	0/5 (0) vs 7/54 (12.7)	> 0.99	0/2 (0) vs 9/24 (37.5)	0.284

¹Comparison made with Fisher’s Exact Test.