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[Aminotransferase levels in rheumatoid arthritis patients treated with methotrexate]
F A Salamea-Palacios1, I M Laurindo, D Y Torigoe
1Disciplina de Reumatologia, Faculdade de Medicina, Universidade de São Paulo.
Abstract:
Increase of the aminotransferase levels in 53 patients treated with methotrexate (MTX) were analysed in a retrospective study. The mean dose of MTX was 7.46 mg/week (range 2.5-15 mg) during at least 30 weeks (mean time of MTX use 124 weeks). The aminotransferase levels were transitorily increased in 13 patients, always less than three times the upper limit of normal. Only in three patients the AST and ALT levels were persistently increased and lead to the drug discontinuation in two cases. These results showed that increase of aminotransferases was a frequent observation (24.5%) during the first two-three years of follow-up, without interference in the overall clinical management.
Insights
Methotrexate (MTX) treatment frequently caused transient aminotransferase elevations in patients. These liver enzyme increases were typically mild and did not significantly impact long-term clinical management.
Area of Science:
- Hepatology
- Pharmacology
- Clinical Medicine
Context:
- Methotrexate (MTX) is a widely used medication with potential hepatic side effects.
- Monitoring liver function is crucial for patients on long-term MTX therapy.
Purpose:
- To analyze the incidence and pattern of aminotransferase level increases in patients treated with methotrexate.
- To assess the clinical significance and management implications of MTX-induced aminotransferase elevations.
Summary:
- A retrospective study analyzed 53 patients receiving methotrexate (mean dose 7.46 mg/week) for at least 30 weeks.
- Transient aminotransferase elevations occurred in 24.5% of patients, usually less than three times the upper limit of normal.
- Persistent elevations requiring drug discontinuation were rare (2 cases).
Impact:
- Aminotransferase increases are a common, generally transient, finding during the initial years of methotrexate therapy.
- These elevations typically do not interfere with the overall clinical management of patients.
- The study highlights the importance of monitoring liver enzymes but suggests a favorable safety profile regarding significant hepatotoxicity.