Muhammad Bilal, Ghazala Shaheen, Syed Hassan Mustafa, Muhammad Nazir, Zulfiqar Ahmad, Taj Muhammad Khan, Rabnawaz Khan.
Hepatic safety of low dose methotrexate therapy in patients with Rheumatoid Arthritis..
Professional Med J Jan ;29(6):791-6.

Objective: To determine the Hepatic safety of low dose methotrexate therapy in patients with Rheumatoid Arthritis. Study Design: Prospective and Descriptive study. Settings: Department of Medicine, Peshawar Institute of Medical Sciences. Period: May 2020 to May 2021. Material & Methods: A total of 151 patients with rheumatoid Arthritis were included in this study. All diagnosed patients were advised baseline liver function tests and routine blood investigations. Patients were started on methotrexate 7.5 mg weekly. On each monthly follow-up visit, liver function tests were done to detect hepatotoxicity. Results: A total of 151 patients of rheumatoid arthritis were included in this study with a female to male ratio of 1.4:1. Average age of the patients was 43.76 years -+ 12.7 SD with range 17-72 years. Only in 17 (11.26%) of patients on 7.5 mg /weekly dose of methotrexate, mild hepato-toxicity was observed based on the elevation of aminotransferases more than two times upper limit of Reference(ULR). Conclusion: Although Hepato-toxicity can occur in a minority of patients on low dose methotrexate therefore in low dose it is a safe drug for the treatment of Rheumatoid Arthritis.

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