Longterm methotrexate therapy in rheumatoid arthritis: a review

A review of the literature on the longterm use of methotrexate in patients with rheumatoid arthritis (RA) showed that many questions on protocol remain unanswered. Although rheumatologists have adopted certain guidelines previously followed by dermatologists for psoriasis patients, rheumatology literature offers no set of rules for using the drug in treating patients with RA. The use of liver function tests and liver biopsy specimens to predict and assess hepatotoxicity associated with methotrexate use is also discussed.