Safety of Methotrexate
Methotrexate is currently the most frequently prescribed second-line agent for the treatment of Juvenile Rheumatoid Arthritis (JRA). Long-term side effects include liver toxicity including hepatic fibrosis. Our center performed a study examining the long-term effects of methotrexate on hepatic tissues of children with JRA. We found that serial biochemical blood abnormalities are significantly associated with the presence of liver fibrosis. These findings concur with studies of patients with rheumatoid arthritis.
Hashkes PJ, Balistreri WF, Bove KE, Ballard ET, Passo MH. The long-term effect of methotrexate therapy on the liver in patients with juvenile rheumatoid arthritis. Arthritis Rheum. 1997; 40:2226-34.
