Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Sep 18, 2017; 9(26): 1092-1100
Published online Sep 18, 2017. doi: 10.4254/wjh.v9.i26.1092
Risk of liver disease in methotrexate treated patients
Richard Conway, John J Carey
Richard Conway, Centre for Arthritis and Rheumatic Diseases, St. Vincent’s University Hospital, Dublin 4, Ireland
Richard Conway, CARD Newman Research Fellow, University College Dublin, Belfield, Dublin 4, Ireland
John J Carey, Department of Rheumatology, Galway University Hospitals, Merlin Park, Galway H91 YR71, Ireland
John J Carey, Clinical Sciences Institute, National University of Ireland Galway, Galway H91 TK33, Ireland
Author contributions: Conway R and Carey JJ wrote the paper.
Conflict-of-interest statement: We report no conflicts of interest for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Richard Conway, Centre for Arthritis and Rheumatic Diseases, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland.
Telephone: +353-876097345 Fax: +353-12214170
Received: February 20, 2017
Peer-review started: February 20, 2017
First decision: April 1, 2017
Revised: April 20, 2017
Accepted: July 7, 2017
Article in press: July 10, 2017
Published online: September 18, 2017
Core Tip

Core tip: Methotrexate is a highly effective treatment for many diseases. In rheumatoid arthritis it controls symptoms, prevents damage, and reduces mortality. The risks of methotrexate use are often over-estimated. Methotrexate may result in asymptomatic transaminase elevations. Historically methotrexate has been infrequently associated with more severe liver adverse events. With modern monitoring and management of liver blood tests serious liver related adverse events related to methotrexate use appear to be avoidable.