When methotrexate was first being used to treat rheumatoid arthritis in the 1970s, as an experimental drug, there were concerns about its effect on the liver. But, routine monitoring of liver enzymes became the safeguard.
According to a report in Rheumatology News, up to one-third of patients taking methotrexate may have discontinued the drug unnecessarily due to mildly elevated liver function tests (less than 1.5 times the upper limit of normal). Researchers are now suggesting that more studies are needed to clearly define the level of abnormal liver function that requires discontinuation. It is possible that too many patients are being cut off from methotrexate too soon.
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