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Updated: Jun 16, 2026
08:43
Investigating Intestinal Inflammation in DSS-induced Model of IBD
Published on: February 1, 2012
Changes in liver biochemistry during methotrexate use for inflammatory bowel disease
Marc R Fournier1, Julianne Klein, Gerald Y Minuk
1Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
The American Journal of Gastroenterology
|February 18, 2010
Summary
Methotrexate use in inflammatory bowel disease (IBD) can cause liver enzyme test (LET) abnormalities, but these often resolve during continued treatment. Discontinuation is rarely needed, with liver biopsies showing minimal abnormalities.
Area of Science:
- Hepatology
- Gastroenterology
- Pharmacology
Background:
- Methotrexate is a common therapy for inflammatory bowel disease (IBD).
- Liver enzyme test (LET) abnormalities are a known potential side effect of methotrexate.
- Characterizing these abnormalities is crucial for safe IBD management.
Purpose of the Study:
- To define the range of liver enzyme test (LET) abnormalities associated with methotrexate use in inflammatory bowel disease (IBD).
- To assess the frequency and outcomes of these liver enzyme test abnormalities.
Main Methods:
- Retrospective review of patients with IBD treated with methotrexate.
- Inclusion criteria: ascertainable cumulative doses, availability of baseline and follow-up LETs.
- Exclusion criteria: rheumatoid arthritis, psoriasis, unavailable dose data.
Main Results:
- Out of 87 patients, 24% developed LET abnormalities.
- Most abnormalities normalized while continuing methotrexate (88% of those with abnormalities).
- Liver biopsies rarely showed significant abnormalities (Roenigk's grade I in 88%).
Conclusions:
- Methotrexate commonly causes LET abnormalities in IBD patients.
- These abnormalities frequently normalize without treatment cessation.
- Drug discontinuation is necessary in only a small percentage of cases.
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