Determine the Prevalence of Methotrexate Induced Hepatotoxicity in Rheumatoid Arthritis Patients whom Treated with Low Dose Methotrexate

Aim: To examine the prevalence of methotrexate affected hepatotoxicity in rheumatoid arthritis patients whom were treated with low dose of methotrexate. Methods: This cross-sectional/observational study was carried out at Department of Medicine, Islam Teaching Hospital, Sialkotfrom 1st July 2017 to 31st December 2017. One hundred and thirty eight patients of both genders having rheumatoid arthritis were included. Patient's ages were ranging from 20 to 60 years. Patients detailed history including, age, sex, socio-economic status was examined after taking informed consent from all the patients. All patients were treated with low dose 7.5mg methotrexate weekly and proper and regular follow up was taken for six months. Results: Forty eight (34.78%) patients were males while rest 65.22% patients were females. 53 (38.41%) patients were ages between 20 to 34 years, 59(42.75%) patients had ages 35 to 49 years and 26 (18.64%) patients were ages >49 years. One hundred (72.46%) patients had rural residency. Mean hemoglobin, bilirubin, alkaline ph, ALT and weight were noted as 11.97 +/- 2.12, 0.96, 22.84 +/- 1.42 and 44.34 +/- 3.6, 64.97 +/- 5.32 respectively. Fifteen (10.87%) patients had found with raised serum ALT. Heptotoxicity was defined as serum ALT of above than two time of reference range. In 48 males' patient, hepatotoxicity was found in 7 patients and in females it was observed in 11 patients. Conclusion: Hepatotoxicity is commonly observed side effect in patients treated with methotrexate. Regular monitoring with serum ALT of these patients necessitate early and proper treatment.