Hepascore predicts liver outcomes and all-cause mortality in long-term methotrexate users: A retrospective cohort study.BACKGROUND AND AIM
 The aim of this study was to investigate whether a serum liver fibrosis test (Hepascore) predicted the risk of adverse liver-related outcomes and mortality.


 A total of 92 patients in Western Australia who had a long-term MTX intake history,from 2004 to 2016, were recruited and followed up from the first Hepascore to death or end of the study.  Baseline Hepascore ≥0.84 was associated with advanced fibrosis on liver biopsy (P = 0.025).  A baseline Hepascore ≥0.84 was significantly associated with higher risks for adverse liver-related outcomes (P < 0.001) and all-cause mortality (P = 0.001).  Cox regression demonstrated that only baseline Hepascore ≥0.84 was independently associated with the increased risk of all-cause mortality (7.91 [1.52-41.29], P = 0.014).  Moreover, any Hepascore ≥0.84 found during follow up was independently associated with the increased risk of all-cause mortality (86.18 [4.03-1844.83], P = 0.007).


 This study demonstrated the potential importance of Hepascore monitoring in long-term MTX users.  Patients with a Hepascore higher than 0.84 at any stage had increased mortality, but further studies are required to confirm this finding.
Hepascore
Hepascore predicts liver outcomes and all-cause mortality in long-term methotrexate users: A retrospective cohort study.BACKGROUND AND AIM
 Methotrexate (MTX) is routinely used for immunological disorders, and its long-term use is associated with hepatotoxicity. 
Methotrexate
A total of 92 patients in Western Australia who had a long-term MTX intake history,from 2004 to 2016, were recruited and followed up from the first Hepascore to death or end of the study. 
Western Australia
Clinical data, all deaths, and liver-related outcomes (liver-related death and decompensation) were obtained from hospital, PathWest, and WA Data Linkage Unit databases.



PathWest
Clinical data, all deaths, and liver-related outcomes (liver-related death and decompensation) were obtained from hospital, PathWest, and WA Data Linkage Unit databases.



WA Data Linkage Unit databases