Related Experiment Video

Updated: Jul 26, 2026

Evaluation of Changes in Hydration and Body Cell Mass with Bioelectrical Impedance Analysis after Exercise Program for Rheumatoid Arthritis Patients
07:44

Evaluation of Changes in Hydration and Body Cell Mass with Bioelectrical Impedance Analysis after Exercise Program for Rheumatoid Arthritis Patients

Published on: July 14, 2023

Cirrhosis in patients with rheumatoid arthritis receiving low dose methotrexate

G Chandran1, M J Ahern, P D Hall

  • 1Department of Medicine, Repatriation General Hospital, Daw Park, South Australia.

British Journal of Rheumatology
|October 1, 1994
PubMed

Insights

Low-dose methotrexate (MTX) can cause cirrhosis in rheumatoid arthritis (RA) patients. A study found a 2.63% prevalence of cirrhosis in RA patients taking low-dose pulse MTX, highlighting potential liver risks.

Area of Science:

  • Hepatology
  • Rheumatology
  • Pharmacology

Background:

  • Methotrexate (MTX) is a common disease-modifying antirheumatic drug (DMARD) used for rheumatoid arthritis (RA).
  • Long-term use of low-dose MTX has been associated with potential liver toxicity, including fibrosis and cirrhosis.
  • Understanding the risk factors and prevalence of MTX-induced liver injury is crucial for patient safety.

Observation:

  • Three rheumatoid arthritis patients developed cirrhosis while on low-dose methotrexate therapy.
  • Two of these cases were identified within a prospective study of 76 RA patients on low-dose pulse MTX.
  • This observation prompted a review of risk factors associated with MTX-induced cirrhosis.

Findings:

  • The point prevalence of cirrhosis in the studied cohort of RA patients on low-dose pulse MTX was 2.63%.
  • The report reviews identified risk factors contributing to the development of cirrhosis in patients using methotrexate.
  • Analysis focused on quantifying changes in pericellular and total collagen in relation to MTX exposure.

Implications:

  • Clinicians should maintain a high index of suspicion for liver damage in RA patients on long-term methotrexate.
  • Regular monitoring of liver function and consideration of cumulative methotrexate dose are essential.
  • Further research into predictive markers for MTX-induced liver cirrhosis may improve patient outcomes.

More Related Videos

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain04:50

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice07:37

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice

Published on: June 6, 2025

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
Cirrhosis I: Introduction01:23

Cirrhosis I: Introduction

Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
Cirrhosis II: Pathophysiology01:24

Cirrhosis II: Pathophysiology

Cirrhosis is a progressive chronic liver injury caused by prolonged inflammation, excessive fibrotic remodeling, and impaired regeneration. Over time, repeated hepatic insults disrupt the liver’s architecture and function, leading to reduced blood flow, impaired bile drainage, and diminished metabolic capacity.Pathophysiology of cirrhosisCirrhosis arises from three main responses to chronic liver damage: inflammation, immune activation, and hepatocyte death. These processes lead to structural...